Serial Abdominal Closure Technique (the "SAC" Procedure): A Novel Method for Delayed Closure of the Abdominal Wall

Kafie, Fernando E.; Tessier, Deron J.; Williams, Russell A.; Podnos, Yale D.; Cinat, Marianne; Lekawa, Michael; Wilson, Samuel E.
February 2003
American Surgeon;Feb2003, Vol. 69 Issue 2, p102
Academic Journal
Case Study
Abdominal compartment syndrome may occur after any elective or emergent abdominal operations that are complicated by postoperative hemorrhage or in the trauma patient who has massive fluid replacement for intra-abdominal bleeding. Once the abdomen is decompressed the type of closure varies as much as the surgeon performing the procedure. We have devised a simple, reproducible, inexpensive, and safe method to close the abdomen at the bedside. Serial abdominal closure (SAC) was performed on three patients 45, 54, and 14 years of age who had developed abdominal compartment syndrome secondary to an upper gastrointestinal bleed requiring massive transfusion, a tear of the superior mesenteric vein, and a grade 4 liver laceration respectively, all necessitating abdominal decompression. All three patients had their abdominal wounds closed at the bedside over the course of several days with our SAC technique. Subsequent postoperative course was uneventful and the abdominal wall was free of defects at one-year follow-up. SAC is an efficient, inexpensive, and easily reproducible method of managing the open abdomen. The use of SAC prevented abdominal closure-related complications such as enteric fistula and hernia formation in our three patients.


Related Articles

  • Lipoabdominoplastia con cicatriz reducida sin neo-onfaloplastia en abdomen tipo III (Matarasso). Centurión, P.; Olivencia, C.; Romero, C.; García, R. Gamarra // Cirugía Plástica Ibero-Latinoamericana;2009, Vol. 35 Issue 4, p271 

    We present an innovative surgical technique for treatment of abdominal region, in which we combine liposculpture and limited-incisions abdominoplasty without neoumbilicoplasty, in Type III Matarasso Classification patients. We conducted a retrospective study of patients undergoing surgery with...

  • Laparoscopic closure of small bowel perforation: Technique of small bowel anchoring to the abdominal wall. Jagad, Rajan B. // Journal of Minimal Access Surgery;Apr2009, Vol. 5 Issue 2, p47 

    INTRODUCTION : More and more complicated laparoscopic abdominal surgeries are now being performed across the world. Laparoscopic suturing of the bowel perforations is being performed by experienced surgeons. We have developed our own technique of small bowel anchoring to the abdominal wall...

  • Applied anatomy of abdominal incisions.  // British Journal of Hospital Medicine (17508460);Mar2010 Supplement, Vol. 71, pM36 

    The article discusses the two most commonly used abdominal incisions in the repertoire of the general abdominal surgeon, namely, the midline incision and the right iliac fossa muscle split incision. It cites several advantages of midline incision including a relatively easy to close and a quick...

  • Laparotomy closure -- continuous or interrupted suture? Zimmer, Wojciech; Urbanek, Tomasz; Stańczyk, Dariusz // Polish Surgery / Chirurgia Polska;2008, Vol. 10 Issue 1, p35 

    Despite many years of experience, the optimal technique of laparotomy closure remains controversial. The variety of the surgical access possibilities, as well as the variety of abdominal closure techniques, are the main difficulties in the proper standardization of this procedure In this paper,...

  • Glove-Assisted Laparoscopic Radical Nephrectomy: A Novel Technique. Nozaki, Tetsuo; Asao, Yoshihiro; Ichimatsu, Keisuke; Ito, Takatoshi; Yasuda, Kenji; Watanabe, Akihiko; Komiya, Akira; Fuse, Hideki // Journal of Laparoendoscopic & Advanced Surgical Techniques;Dec2010, Vol. 20 Issue 10, p843 

    Background: Laparoscopic surgery has not yet met with widespread acceptance due to its degree of technical difficulty. The laparoscopic radical nephrectomy procedure was improved with the aid of an abdominal wall sealing device, a wound retractor, and a surgical glove. Methods: A 5 cm skin...

  • Intraperitoneal Tension-free Repair of a Small Midline Ventral Abdominal Wall Hernia: Randomized Study with a Mean Follow-up of 3 Years. BENSAADI, HOCINE; PAOLINO, LUCA; VALENTI, ANTONIO; POLLIAND, CLAUDE; BARRAT, CHRISTOPHE; CHAMPAULT, GÉRARD // American Surgeon;Jan2014, Vol. 80 Issue 1, p57 

    Funding received from Cousin Biotech, Wervicq Sud, France, and CR Bard Inc., Cranston, RI. The aim of this prospective randomized study was to determine the long-term recurrence and complication rates after small abdominal wall hernia repair with two different bilayer prostheses. Hernia repair...

  • Laparoscopic Excision of Symptomatic Urachal Anomalies: A Technique to Restore the Natural Appearance of the Umbilicus. Nozaki, Tetsuo; Ichimatsu, Keisuke; Ito, Takatoshi; Yasuda, Kenji; Watanabe, Akihiko; Fuse, Hideki // Journal of Laparoendoscopic & Advanced Surgical Techniques;Dec2010, Vol. 20 Issue 10, p821 

    Background: Recent reports on laparoscopic surgery for urachal anomalies have not described any techniques to restore the natural appearance of the umbilicus. In this report, we present a simple technique that enables complete resection of urachal anomalies while preserving the natural...

  • Intake of Temporary Abdominal Closure with Abdominal Negative-pressure Therapy in Management of Nontraumatic Abdominal Surgical Emergencies to Avoid Stoma. Malgras, Brice; Pasquier, Pierre; Savard, Dillon J.; Rouquie, Delphine; Baton, Olivier; Boulanger, Thierry; Goudard, Yvain; Chapuis, Olivier // American Surgeon;Nov2014, Vol. 80 Issue 11, pE314 

    The article discusses a study on the use of temporary abdominal closure (TAC) with abdominal negative-pressure therapy (ANPT) in situations requiring damage control surgery (DCS) with digestive tract resections. Topics discussed include the benefits of TAC such as the prevention of prolonged...

  • The Oscar Ramirez Procedure, a Solution for Treating Incisional Hernias with Big Abdominal Wall Defect. Gherghinescu, M.; Popa, D.; Panțiru, A.; Russu, C.; Roșca, C.; Benedek, Orsolya; Copotoiu, C. // Acta Medica Marisiensis;Jun2014, Vol. 60 Issue 3, p122 

    Background: Incisional hernias are important complications of abdominal surgery. Normally they are followed by the growth of the hernia sac and an increase of the abdominal wall defect with loss of domain of the herniated organs. Case report: We report a case of a 51 year old female, admitted in...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics