Open abdomen treatment following endovascular repair of ruptured abdominal aortic aneurysms Dieter Mayer, MD, Zoran Rancic, MD, PhD, Christoph Meier,

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Presentation transcript:

Open abdomen treatment following endovascular repair of ruptured abdominal aortic aneurysms Dieter Mayer, MD, Zoran Rancic, MD, PhD, Christoph Meier, MD, Thomas Pfammatter, MD, Frank J. Veith, MD, Mario Lachat, MD Journal of Vascular Surgery Volume 50, Issue 1, Pages 1-7 (July 2009) DOI: 10.1016/j.jvs.2008.12.030 Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 1 General algorithm for open abdomen treatment after emergency endovascular aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (RAAA). ACS, Abdominal compartment syndrome; ICU, intensive care unit. *For risks, see the Table. Journal of Vascular Surgery 2009 50, 1-7DOI: (10.1016/j.jvs.2008.12.030) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 2 Algorithm to choose the optimal type of open abdomen treatment (OAT) after emergency endovascular aneurysm repair (eEVAR) for ruptured abdominal aortic aneurysm (RAAA). VAC, Vacuum assisted closure; VAC/ETHIZIP, VAC-over-ETHIZIP. Journal of Vascular Surgery 2009 50, 1-7DOI: (10.1016/j.jvs.2008.12.030) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 3 Temporary abdominal closure with a simple, large sterile plastic drape or bag allows direct visualization of the bowel and further swelling of the abdomen without pressure rise. Journal of Vascular Surgery 2009 50, 1-7DOI: (10.1016/j.jvs.2008.12.030) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 4 A ring shaped black polyurethane foam of the vacuum-assisted closure system is put near the border where the Bogota bag is sutured to the skin. The adhesive foils just cover the polyurethane foam, not the whole bag silo. The TRAC-PAD (KCI International Inc, Amstelveen, The Netherlands) of the vacuum-assisted closure system is positioned so that it doesn't interfere with the bag or skin. Journal of Vascular Surgery 2009 50, 1-7DOI: (10.1016/j.jvs.2008.12.030) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 5 Zipper drape placed sutureless underneath the entire abdominal wall. Journal of Vascular Surgery 2009 50, 1-7DOI: (10.1016/j.jvs.2008.12.030) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 6 Polyurethane foam applied over the ETHIZIP with suction of 50 to 100 mm Hg. Journal of Vascular Surgery 2009 50, 1-7DOI: (10.1016/j.jvs.2008.12.030) Copyright © 2009 Society for Vascular Surgery Terms and Conditions