open abdomen and fistula's

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Eric,

What is the rate of infectious complication, or that of primary alloderm failure?

Doug

-----Original Message-----
From: trauma-list-bounces at trauma.org on behalf of docrickfry at aol.com
Sent: Wed 6/22/2005 7:30 AM
To: trauma-list at trauma.org
Subject: Re: open abdomen and fistula's
 
It does not absorb and go away unless some infectious complication happens--it actually becomes new fascia thru ingrowth from the tissue it is sutured to, and definitively restores the abdominal wall without the inevitable ventral hernia we know occurs after absorbable mesh like vicryl.  One author described reoperating on a patient with alloderm one year after placing it, and could not tell the difference from normal fascia.  Again, there is a growing body of literature on this in the journals.
ERF 
 
-----Original Message-----
From: Geehan, Douglas <geehand at umkc.edu>
To: Trauma & Critical Care mailing list <trauma-list at trauma.org>
Sent: Wed, 22 Jun 2005 07:16:22 -0500
Subject: RE: open abdomen and fistula's


Ron, Steve,
 
What advantage over vicryl mesh?
 
Regards,
 
Doug

________________________________

From: trauma-list-bounces at trauma.org on behalf of Ronald Simon
Sent: Wed 6/22/2005 5:24 AM
To: Trauma & Critical Care mailing list
Subject: Re: open abdomen and fistula's



I have used it several times instead of the more complex component
release. Has worked like a charm.
Ron Simon, MD

flysurg at aol.com wrote:

>I have used Alloderm over the past 2 years to close the open abdomen. It seems 
to work, no fistulae so far, but it is rediculously expensive and there is 
precious little literature to support its use for this purpose. Any thoughts 
from the list?
>
>Steve Smith
>
>-----Original Message-----
>From: docrickfry at aol.com
>To: trauma-list at trauma.org
>Sent: Tue, 21 Jun 2005 08:25:22 -0400
>Subject: Re: open abdomen and fistula's
>
>
>Well--of course it is better to close the abdomen, and certainly an open 
abdomen
>increases the risk of fistula.  This is not disputed at all.  The ONLY
>indication to leave an abdomen open long term is an inability to close it--very
>simple.  The important thing to recognize and appreciate is when this is
>necessary or advisable.
>ERF 
>
>-----Original Message-----
>From: Maureen Canavan <scho26 at sbcglobal.net>
>To: Trauma & Critical Care mailing list <trauma-list at trauma.org>
>Sent: Mon, 20 Jun 2005 20:45:22 -0700 (PDT)
>Subject: Re: open abdomen and fistula's
>
>
>I'm speaking of the original injury,whether its a gsw or sw, is it better to
>close or leave it open? Can leaving these abdomens open leave the patient to
>possible fistula's in their future?
>
>Ronald Simon <Traumamd at nyc.rr.com> wrote:I try and close both when the patient
>is ready to have the abdomen
>closed. Closing the fistula with the abdomen open has increased risk of
>recurrence, IMHO.
>Ron Simon, MD
>
>Maureen Canavan wrote:
>
> 
>
>>I'm seeing a higher number of fistula's in open abdomens what is the current
>>   
>>
>study on this? Leave them open or close them?
> 
>
>>Simon Houstoun wrote:Thanks very much Tim
>>
>>
>>   
>>
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