Stepwise plication of abdominal mesh technique for open abdomen closure.
| Title: | Stepwise plication of abdominal mesh technique for open abdomen closure. |
|---|---|
| Authors: | Adão D; Universidade Federal de São Paulo - Escola Paulista de Medicina - Departamento de Cirurgia - São Paulo (SP) - Brazil.; Maluf FC; Universidade Federal de São Paulo - Escola Paulista de Medicina - Departamento de Cirurgia - São Paulo (SP) - Brazil.; Martins GCL; Universidade Federal de São Paulo - Escola Paulista de Medicina - Departamento de Cirurgia - São Paulo (SP) - Brazil.; Colleoni Neto R; Universidade Federal de São Paulo - Escola Paulista de Medicina - Departamento de Cirurgia - São Paulo (SP) - Brazil.; Scalabrini M; Universidade Federal de São Paulo - Escola Paulista de Medicina - Departamento de Cirurgia - São Paulo (SP) - Brazil.; Grande LMD; Universidade Federal de São Paulo - Escola Paulista de Medicina - Departamento de Cirurgia - São Paulo (SP) - Brazil. |
| Source: | Acta cirurgica brasileira [Acta Cir Bras] 2026 Jun 29; Vol. 41, pp. e413426. Date of Electronic Publication: 2026 Jun 29 (Print Publication: 2026). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Sociedade Brasileira Para O Desenvolvimento Da Pesquisa Em Cirurgia Curso De Pos-Graduacao Em Tecnica Operatoria E Cirurgia Experimental Escola Paulista De Medicina Country of Publication: Brazil NLM ID: 9103983 Publication Model: eCollection Cited Medium: Internet ISSN: 1678-2674 (Electronic) Linking ISSN: 01028650 NLM ISO Abbreviation: Acta Cir Bras Subsets: MEDLINE |
| Imprint Name(s): | Publication: Sao Paulo : Sociedade Brasileira Para O Desenvolvimento Da Pesquisa Em Cirurgia Curso De Pos-Graduacao Em Tecnica Operatoria E Cirurgia Experimental Escola Paulista De Medicina; Original Publication: São Paulo : A Sociedade |
| MeSH Terms: | Negative-Pressure Wound Therapy*/methods ; Abdominal Wall*/surgery ; Surgical Mesh* ; Abdominal Wound Closure Techniques* ; Open Abdomen Techniques*; Humans ; Female ; Male ; Adult ; Middle Aged ; Treatment Outcome ; Suture Techniques ; Time Factors |
| Abstract: | Purpose: To present the stepwise plication of abdominal mesh (SPAM) as a standardized dynamic closure technique that combines mesh-mediated fascial traction with negative pressure wound therapy for gradual abdominal wall approximation.; Methods: In this technical report, we present SPAM for progressive closure of peritoneostomy with excessive abdominal wall retraction. It involves a central mesh incision followed by progressive tightening via hemostatic clamp rotation (similar to opening a can with a key), without full-thickness mesh cut. The mesh is secured with continuous suture and covered with a non-commercial negative pressure system. Cycles are repeated every 48-72 hours until fascial closure.; Results: SPAM was applied in four patients: three successful cases (52-year-old male with rectal perforation, 36-year-old female post-Hartmann evisceration, 63-year-old female with gastrojejunal anastomosis leak) achieved primary fascial closure in a median of 10 days, with well-tolerated traction, no enteroatmospheric fistula, or incisional hernia. In one failure (59-year-old male with gastrojejunal leak post-laparoscopic gastrectomy), bleeding occurred during traction (controlled surgically), yet the technique was discontinued due to progressive clinical deterioration.; Conclusion: SPAM offers a practical, standardized, reproducible approach to delayed fascial closure, particularly in resource-limited settings, enabling controlled progressive approximation without mesh resection. |
| Entry Date(s): | Date Created: 20260701 Date Completed: 20260701 Latest Revision: 20260726 |
| Update Code: | 20260726 |
| PubMed Central ID: | PMC13318264 |
| DOI: | 10.1590/acb413426 |
| PMID: | 42384994 |
| Database: | MEDLINE |
Journal Article