Suction drain retention sutures in the closure of the acute burst abdomen.

摘要

The incidence of burst abdomens is reported to be 3% with a mortality of 25%.Burst abdomens are managed by the control of wound infection and primary closure. Deep tension sutures are frequently used to give further support to the abdominal wall. We describe a variation on deep retention sutures, which gives adequate support to the abdominal wall with no risk of 'cutting out'. Following debridement of the abdominal wall, three to four suction drain tubes are disconnected from their collecting flasks. The tubing should be a gauge small enough to allow it to be knotted easily. The suction drain tubes are then placed 'through and through' the abdominal wall. The abdominal wall is closed using a continuous suture; as the surgeon progresses down the laparot-omy wound, the suction drain tubing is knotted over the abdominal wound for further support (Fig. 1). In cases of gross contamination, mass closure can be omitted to give a controlled laparostoma. The drains are left in situ for 4 weeks before removal.