METHOD OF MESH MEDIALIZATION OF WOUND EDGES DURING VACUUM-ASSISTED LAPAROSTOMY IN PATIENTS WITH COMBINED CLOSED ABDOMINAL TRAUMA AND PERITONITIS Russian patent published in 2024 - IPC A61B17/03 A61B17/00 A61F2/00 A61M1/00 

FIELD: medicine; surgery.

SUBSTANCE: invention can be used for vacuum-assisted laparostomy in patients with combined closed abdominal trauma and peritonitis. A mesh is formed based on the diastasis of the wound edges and intra-abdominal pressure so that its width is 2–3 cm greater than the width of the wound. After fixing one edge of the mesh to the edge of the wound, the second edge of the mesh is placed under the aponeurosis above the plastic film at a distance of 2–3 cm from the edge of the wound. The wound is fixed with interrupted sutures in the middle and at both corners of the laparotomy wound. The needle is inserted at a distance from the edge of the wound through the skin, subcutaneous fatty tissue (SAT), and the aponeurosis of the external oblique abdominal muscle. An injection is made into the mesh at a distance of 1–2 cm from the free edge of the mesh, and the thread is passed over the plastic film. The puncture is performed through the mesh at a distance from the injection, through the aponeurosis, pancreas and skin. The mesh is fixed and the necessary medialization of the wound edges is performed, tightening the sutures, a foam sponge, a sealing film and a device for vacuum aspiration are installed.

EFFECT: method is simple, reliable and effective, provides quick fixation of the mesh during the application of a vacuum system, reduces the time of access to the abdominal cavity during relaparotomy, reduces the risk of trauma to the abdominal organs and fibre disintegration of the implant, which increases the effectiveness of treatment, reduces the risk of a “frozen abdomen”, complications of traumatic disease by reducing the time interval of primary laparotomy in patients with damage control tactics.

1 cl, 9 dwg, 1 ex