J Korean Soc Traumatol.  2013 Mar;26(1):14-17.

Early Definitive Closure of an Open Abdomen by Using Porcine Dermal Collagen Graft: A Case Report

• Park SJ
• Kim JH
• Yun SP
• Choi SW
• Kim SH

Abstract

PURPOSE
The open abdomen is now the standard of care in various clinical situations, especially it is used to treat abdominal compartment syndrome. Many techniques have been reported for closure after an open abdomen, but most take a long time for complete definitive closure and are associated with various problems. We describe a technique using biologic mesh that can achieve early definitive closure after an open abdomen.
METHODS
A 45-year-old man presented to the emergency room with a painful hip and painful lower extremities after a fall from 80 feet. Radiologic examination revealed multiple fractures of the pelvis and low extremities. Abdominal compartment syndrome caused by a retroperitoneal hematoma developed during the orthopedic surgery. We performed exploration immediately and closed abdomen temporarily. A peritoneal graft of porcine dermal collagen with anterior myofascial approximation of the rectus abdominis muscles and sliding skin flap was performed three days after the previous surgery.
RESULTS
There were no complications related to the wound. The patient was transferred to the Department of Orthopedic Surgery seven days after the initial surgery.
CONCLUSION
Early definitive closure using porcine dermal collagen is a feasible method that can reduce the length of hospitalization and the number of operations for an open abdomen.

Keyword

Abdominal compartment syndrome; Damage control surgery; Definitive closure; Porcine dermal collagen

MeSH Terms

Abdomen
Collagen
Emergencies
Extremities
Foot
Hematoma
Hip
Hospitalization
Humans
Intra-Abdominal Hypertension
Lower Extremity
Muscles
Orthopedics
Pelvis
Rectus Abdominis
Skin
Standard of Care
Transplants
Collagen