Early abdominal closure with mesh reduces multiple organ failure after ruptured abdominal aortic aneurysm repair: Guidelines from a 10-year case-control.

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Presentation transcript:

Early abdominal closure with mesh reduces multiple organ failure after ruptured abdominal aortic aneurysm repair: Guidelines from a 10-year case-control study Todd E. Rasmussen, MDa, John W. Hallett, MDb, Audra A. Noel, MDb, Gregory Jenkins, BSb, Thomas C. Bower, MDb, Kenneth J. Cherry, MDb, Jean M. Panneton, MDb, Peter Gloviczki, MDb Journal of Vascular Surgery Volume 35, Issue 2, Pages 246-253 (February 2002) DOI: 10.1067/mva.2002.120384 Copyright © 2002 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 1 A, Ruptured abdominal aortic aneurysm with associated retroperitoneal hematoma and reduction of abdominal domain. B, Standard primary abdominal closure of compromised abdominal space after ruptured aneurysm repair with compression of abdominal structures. C, Closure of abdomen with impermeable mesh or Silastic sheeting expands abdominal domain and reduces pressure on abdominal structures. Journal of Vascular Surgery 2002 35, 246-253DOI: (10.1067/mva.2002.120384) Copyright © 2002 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 2 Charts of 223 patients with ruptured abdominal aortic aneurysms were reviewed. Fifty-three cases of mesh abdominal closure after operation were identified as compared with 170 cases of standard primary abdominal closure. Journal of Vascular Surgery 2002 35, 246-253DOI: (10.1067/mva.2002.120384) Copyright © 2002 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 3 Multiple organ failure scores at 12 hours, 48 hours, and 7 days after ruptured abdominal aortic aneurysm repair. MOF, Multiple organ failure; SEM, standard error of the mean. Journal of Vascular Surgery 2002 35, 246-253DOI: (10.1067/mva.2002.120384) Copyright © 2002 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 4 In-hospital mortality and death rates from multiple organ failure (MOF) in patients who underwent early mesh closure as compared with patients who underwent late mesh closure after decompressive laparotomy. Journal of Vascular Surgery 2002 35, 246-253DOI: (10.1067/mva.2002.120384) Copyright © 2002 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 5 Algorithm for consideration of clinical factors in use of mesh-based abdominal closure after ruptured abdominal aortic aneurysm repair. SBP, Systolic blood pressure. Journal of Vascular Surgery 2002 35, 246-253DOI: (10.1067/mva.2002.120384) Copyright © 2002 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions