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. 2001 Dec;136(12):1359-62; discussion 1363.
doi: 10.1001/archsurg.136.12.1359.

Dynamic retention: a technique for closure of the complex abdomen in critically ill patients

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Dynamic retention: a technique for closure of the complex abdomen in critically ill patients

L G Koniaris et al. Arch Surg. 2001 Dec.

Abstract

Management of the open abdomen in the setting of massive visceral swelling or extensive intra-abdominal abscess may pose an extremely difficult surgical scenario. We herein describe the technique and results of dynamic-retention sutures used in 13 patients with abdominal catastrophes after trauma, vascular reconstruction, tumor extirpation, and intra-abdominal infection. Three of these patients died during their acute care hospitalization. The remaining 10 patients were discharged to home with no resultant fistulas and 1 recurrent hernia (10%). Dynamic-retention sutures provide a useful technique for the closure of the complex surgical abdomen. We observed a low complication rate. In properly selected patients, this technique avoids the use of mesh or additional surgical procedures such as skin grafting or plastic surgical reconstruction of the abdominal wall.

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