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Charles E. Lucas, MD
Detroit, Mich

Arch Surg. 2001;136:1363.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The surgical modus operandi calls for routine closure of the abdomen. Many surgeons have closed the abdomen under tension, thinking the subsequent development of renal shutdown, respiratory failure, and/or necrotizing fasciitis is unrelated. Koniaris and colleagues present a select patient subset in whom innovative techniques must be applied. Their dynamic-retention suture technique mirrors a procedure used by Dr Ledgerwood and myself¹ and our progeny for more than 30 years: the inner layer of bowel bag (vs army surplus parachute silk) and a second layer of burn dressing (vs fluffs) are secured by extraperitoneally placed large, nonabsorbable sutures. Additional exterior dressings and drainage catheters help contain extensive peritoneal fluid that continually drains. The authors highlight many complications with other techniques, namely, bowel fistulae with mesh, refractory infection and abscess with nonabsorbable mesh and Gore-Tex bridging grafts, wound disruption with absorbable mesh, and the need for later abdominal . . . [Full Text of this Article]

RELATED ARTICLE

Dynamic Retention: A Technique for Closure of the Complex Abdomen in Critically Ill Patients
Leonidas G. Koniaris, Richard J. Hendrickson, George Drugas, Peter Abt, and Luke O. Schoeniger
Arch Surg. 2001;136(12):1359-1362.
ABSTRACT | FULL TEXT