@entity39 in XXXX . Successful management by debridement, myocutaneous advancement, and primary skin closure.

@entity1 @entity39 @entity281 @entity601 @entity86 @entity547 @entity881
Wound management following laparotomy for @entity86 and varying degrees of @entity39 remains a challenging and controversial problem. Because maintained peritoneal integrity and primary wound closure offer the best opportunity for survival, an original technique involving bilateral incisions to relax skin and rectus fascia is proposed. This technique permits medial myocutaneous advancement and primary tension-free skin closure of midline laparotomy incisions. Sixty-nine @entity1 with severe @entity86 were treated according from 1980 through 1985. Nine of these @entity1 died of advanced @entity881 soon after referral, and eight more died after prolonged treatment. Fourteen @entity1 had one or more reoperations for complications. Only nine wound failures resulted, including five eviscerations and four wound @entity281 followed by progressive dehiscence. The bilateral relaxing incisions healed secondarily without complication. Survivors developed midline wound @entity547 ; ten of the 52 surviving @entity1 have had these repaired. This method of primary closure is safe when performed in conjunction with rigorous surgical care of intraperitoneal @entity281 and may enhance survival. We recommend the technique to surgeons who treat severe @entity86 and @entity39 of @entity601 .
