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The Wittmann Patch is a temporary abdominal fascia prosthesis for the planned open abdomen to ease the management of cases where the abdomen cannot be closed due to abdominal compartment syndrome or because multiple further operations are planned (damage control repair [DCR]).
The reconstructive ladder is the set of levels of increasingly complex management of wounds in reconstructive plastic surgery. [1] The surgeon should start on the lowest rung and move up until a suitable technique is reached.
Secondary puncture can be performed when: 1) primary puncture was not possible, 2) for re-puncture after closure of a previous tracheo-esophageal puncture, 3) because of physician or patient preference, and 4) in case failure of esophageal or electrolarynx speech if this was chosen as the initial speech option. [citation needed]
Bogota bag used in the treatment of abdominal compartment syndrome. [1]A Bogota bag is a sterile plastic bag used for closure of abdominal wounds. [2] It is generally a sterilized 3-liter (0.66 imp gal; 0.79 U.S. gal) genitourinary irrigation bag that is sewn to the skin or fascia of the anterior abdominal wall.
(Delayed primary closure): The wound is initially cleaned, debrided and observed, typically 4 or 5 days before closure. The wound is purposely left open. Examples: healing of wounds by use of tissue grafts. If the wound edges are not reapproximated immediately, delayed primary wound healing transpires.
The end goal of wound management is closure of the wound which can be achieved by primary closure, delayed primary closure, or healing by secondary intention, each of which is discussed below. Pain control is a mainstay of wound management, as wound evaluation, wound cleansing, and dressing changes can be a painful process. [27]
Hints and the solution for today's Wordle on Saturday, November 30.
The concern for early closure of the abdomen with development of compartment syndrome is a real one. A method to pre-emptively evaluate whether fascial closure is appropriate would be to determine the difference in peak airway pressure (PAP) prior to closure and the right after closure.