Abstract

KRUGER, H; COUCH, DG  and  OOSTHUIZEN, GV. Skin-only closure as a temporary abdominal closure technique in a rural setting - exploring role and safety profile. S. Afr. j. surg. [online]. 2021, vol.59, n.1, pp.20-24. ISSN 2078-5151.  http://dx.doi.org/10.17159/2078-5151/2021/v59n1a3400.

BACKGROUND: Acute laparotomy for trauma or sepsis often prevents definitive closure due to need for relook laparotomy or to prevent abdominal compartment syndrome. Skin-only closure is widely used in our setting. In this study, we review the safety and effectiveness of this techniqueMETHODS: Patients presenting with intra-abdominal pathology undergoing acute laparotomy and then subsequent skin-only closure using 2-0 prolene were included in the study and followed postoperatively for a three-month period for adverse events stratified by Clavien-Dindo grading, and rate of definitive closureRESULTS: During the study period, twenty-five patients underwent emergent laparotomy and skin-only closure. The median age of patients undergoing skin-only closure was 27 years (standard deviation 9.1). Six patients presented with major trauma and 19 presented with sepsis. Twenty-one patients underwent subsequent fascial closure. One patient was unable to undergo fascial closure and was managed as a planned ventral hernia. Fourteen patients developed a postoperative complication. There were no deaths and no readmissions to intensive care. Three further patients developed a ventral herniaCONCLUSION: Skin-only closure, in carefully selected patients, is a feasible alternative to other temporary abdominal closure techniques in a resource-constrained setting

Keywords : damage control; skin-only closure; temporary abdominal closure; hernia.

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