title: Improved zipper closure of the abdominal wall in patients requiring multiple intra-abdominal operations.
abstract: Optimal management of pancreatic abscess and septic complications of acute pancreatitis remains controversial. With the "open packing" approach, repeated closure of the midline fascia is complicated by loss of tissue integrity and suture strength. An improved zipper closure of the abdominal wall in six patients with pancreatic abscess is presented. Improvements included: (1) using a separating jacket-type zipper to allow maximal intraoperative exposure; (2) employing a removable tuck for expansion of the patch covering the wound; (3) substituting a nonmeshed polytetrafluoroethylene material for the polypropylene mesh to prevent adherence to the underlying viscera; and (4) creating a flap underneath the zipper teeth to protect the underlying tissue from injury. Satisfactory results were achieved with the improved zipper technique.
authors.affiliation: Ochsner Transplant Center, New Orleans, Louisiana.
authors.forename: S
authors.initials: S
authors.lastname: Mizrahi
authors.forename: M
authors.initials: M
authors.lastname: Deutsch
authors.forename: D
authors.initials: D
authors.lastname: Hayes
authors.forename: S
authors.initials: S
authors.lastname: Meshkind
authors.forename: B
authors.initials: B
authors.lastname: Sorant
authors.forename: J
authors.initials: J
authors.lastname: Hussey
authors.forename: J P
authors.initials: JP
authors.lastname: Boudreaux
mesh_terms: D000009:Abdominal Muscles / Q000601:surgery*; D000038:Abscess / Q000601:surgery; D006801:Humans; D010182:Pancreatic Diseases / Q000601:surgery; D011138:Polytetrafluoroethylene; D012086:Reoperation / Q000295:instrumentation; D013525:Surgical Instruments; D013526:Surgical Mesh; D013536:Suture Techniques / Q000295:instrumentation*
chemical_list: D011138:Polytetrafluoroethylene