Journal of Vascular Surgery
Volume 50, Issue 1 , Pages 1-7 , July 2009

Open abdomen treatment following endovascular repair of ruptured abdominal aortic aneurysms

  • Dieter Mayer, MD

      Affiliations

    • Clinic for Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland
    • Corresponding Author InformationCorrespondence: Dieter Mayer, Clinic for Cardiovascular Surgery, University Hospital of Zurich, Raemistrasse 100, 8091 Zurich, CH
    • ,
  • Zoran Rancic, MD, PhD

      Affiliations

    • Clinic for Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland
    • ,
  • Christoph Meier, MD

      Affiliations

    • Clinic for Trauma Surgery, University Hospital of Zurich, Zurich, Switzerland
    • ,
  • Thomas Pfammatter, MD

      Affiliations

    • Clinic for Interventional Radiology, University Hospital of Zurich, Zurich, Switzerland
    • ,
  • Frank J. Veith, MD

      Affiliations

    • The Cleveland Clinic and New York University Medical Center, New York, and University Hospital of Zurich, Zurich, Switzerland
    • ,
  • Mario Lachat, MD

      Affiliations

    • Clinic for Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland

Received 19 October 2008 ,Accepted 16 December 2008.

  • Image Result

    General algorithm for open abdomen treatment after emergency endovascular aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (RAAA). ACS, Abdominal compartment syndrome; ICU, intensive care

    General algorithm for open abdomen treatment after emergency endovascular aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (RAAA). ACS, Abdominal compartment syndrome; ICU, intensive care unit. *For risks, see the Table.

  • Image Result
    Algorithm to choose the optimal type of open abdomen treatment (OAT) after emergency endovascular aneurysm repair (eEVAR) for ruptured abdominal aortic aneurysm (RAAA). VAC, Vacuum assisted closure; V

    Algorithm to choose the optimal type of open abdomen treatment (OAT) after emergency endovascular aneurysm repair (eEVAR) for ruptured abdominal aortic aneurysm (RAAA). VAC, Vacuum assisted closure; VAC/ETHIZIP, VAC-over-ETHIZIP.

  • Image Result
    Temporary abdominal closure with a simple, large sterile plastic drape or bag allows direct visualization of the bowel and further swelling of the abdomen without pressure rise.

    Temporary abdominal closure with a simple, large sterile plastic drape or bag allows direct visualization of the bowel and further swelling of the abdomen without pressure rise.

  • Image Result
    A ring shaped black polyurethane foam of the vacuum-assisted closure system is put near the border where the Bogota bag is sutured to the skin. The adhesive foils just cover the polyurethane foam, not

    A ring shaped black polyurethane foam of the vacuum-assisted closure system is put near the border where the Bogota bag is sutured to the skin. The adhesive foils just cover the polyurethane foam, not the whole bag silo. The TRAC-PAD (KCI International Inc, Amstelveen, The Netherlands) of the vacuum-assisted closure system is positioned so that it doesn't interfere with the bag or skin.

  • Image Result
    Zipper drape placed sutureless underneath the entire abdominal wall.

    Zipper drape placed sutureless underneath the entire abdominal wall.

  • Image Result
    Polyurethane foam applied over the ETHIZIP with suction of 50 to 100 mm Hg.

    Polyurethane foam applied over the ETHIZIP with suction of 50 to 100 mm Hg.

 Competition of interest: none.

PII: S0741-5214(08)02267-2

doi: 10.1016/j.jvs.2008.12.030

Journal of Vascular Surgery
Volume 50, Issue 1 , Pages 1-7 , July 2009

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