Some considerations on "synthesis of large wounds of the body wall with rubber elastic band"

Denadai, Rafael

doi:10.1590/S0102-67202012000100018

LETTER TO EDITOR

Some considerations on "synthesis of large wounds of the body wall with rubber elastic band"

Rafael Denadai

Faculty of Medicine, University of Marilia, SP, Brazil. email: silva.rdp@hotmail.com

To the Editor:

I have read with great interest the article by Dr. Petroianu1. In this letter, besides applauding the excellent technical innovation, I include some considerations on the subject.

1. Concomitant to the use of negative pressure therapy (simple handling and easy acquisition2) with elastic strips1, similar to that proposed by other groups3-5 (partial approximation of the fascia of the rectus abdominalis associated with vacuum system), can potentiate the effects of each technique, reducing the time spent to early healing and reducing stress on the edges of the wound and, so, improving the results.

2. Although not being the scope of the article1, the 21 abdominal wounds could be classified into sub-groups5 in order to facilitate both the conduction of comparative measurements between the different groups (for example, healing time) and the comparison of the results for future studies (using straps or other sustention treatments) and improving the patients care6.

3. As the technical knowledge based on recent number of cases described this technique as a disadvantage compared to other methods7, after the initial proposal of author8, the increase in the number of cases operated on 1, 9.10, resulted in improvement of the technical performance, and therefore the results? What were the differences and / or similarities in the results presented subsequently?

4. In the literature, the aesthetic results and patients' perceptions of their scars have been measured through numerous assessment tools previously validated11, objectively or subjectively12. There is also a quantitative method described by the Dr. Petroianu group13. Once the objective and subjective measurement of the scars is essential for clinical practice (evaluating the results of studies), and facilitates communication among surgeons, enabling a comparison between studies12 (using elastic bands or not)14, witch were the criteria used in evaluation of the results of the study (described as "excellent") and perceptions of patients (shown as "all happy")?

1. Petroianu A. Síntese de grandes feridas da parede corpórea com tira elástica de borracha. ABCD Arq Bras Cir Dig 2010;23:16-18.
2. Campbell AM, Kuhn WP, Barker P. Vacuum-assisted closure of the open abdomen in a resource-limited setting. S Afr J Surg 2010;48:114-115.
3. Cothren CC, Moore EE, Johnson JL, Moore JB, Burch JM. One hundred percent fascial approximation with sequential abdominal closure of the open abdomen. Am J Surg 2006;192:238-242.
4. Navsaria PH, Bunting M, Omoshoro-Jones J, Nicol AJ, Kahn D. Temporary closure of open abdominal wounds by the modified sandwich-vacuum pack technique. Br J Surg 2003;90:718-722.
5. Hilliard ST, Chew KY, Chung AY, Tan B. Improving vacuum-assisted closure of widely open abdomens with improvised elastic sutures. Eur J Plast Surg 2011; [Article in Press]
6. Björck M, Bruhin A, Cheatham M, Hinck D, Kaplan M, Manca G, Wild T, Windsor A. Classification-important step to improve management of patients with an open abdomen. World J Surg 2009;33:1154-1157.
7. van As AB, Navsaria P, Numanoglu A, McCulloch M. Modified sandwich vacuum pack technique for temporary closure of abdominal wounds: an African perspective. Acta Clin Belg Suppl 2007;(1):215-219.
8. Petroianu A. Opção técnica para a síntese de grandes feridas da parede corpórea. Rev Col Bras Cir 2009;36:353-355.
9. Petroianu A. Closure of large wounds of the body wall with elastic rubber strip. Am Surg 2010;76:E168-169.
10. Petroianu A. Synthesis of large wounds of the body wall with rubber elastic band. Acta Med Port 2011;24:427-430.
11. Durani P, McGrouther DA, Ferguson MW. Current scales for assessing human scarring: a review. J Plast Reconstr Aesthet Surg 2009;62:713-720.
12. Verhaegen PD, van der Wal MB, Middelkoop E, van Zuijlen PP. Objective scar assessment tools: a clinimetric appraisal. Plast Reconstr Surg 2011;127:1561-1570.
13. Vidigal FM, Petroianu A. Avaliação de cicatrizes cutâneas: apresentação de um método quantitativo. Rev Col Bras Cir 2010;37:121-127.
14. Barkun JS, Aronson JK, Feldman LS, Maddern GJ, Strasberg SM; Balliol Collaboration, Altman DG, Barkun JS, Blazeby JM, Boutron IC, Campbell WB, Clavien PA, Cook JA, Ergina PL, Flum DR, Glasziou P, Marshall JC, McCulloch P, Nicholl J, Reeves BC, Seiler CM, Meakins JL, Ashby D, Black N, Bunker J, Burton M, Campbell M, Chalkidou K, Chalmers I, de Leval M, Deeks J, Grant A, Gray M, Greenhalgh R, Jenicek M, Kehoe S, Lilford R, Littlejohns P, Loke Y, Madhock R, McPherson K, Rothwell P, Summerskill B, Taggart D, Tekkis P, Thompson M, Treasure T, Trohler U, Vandenbroucke J. Evaluation and stages of surgical innovations. Lancet 2009;374:1089-1096.

Publication Dates

Publication in this collection
03 May 2012
Date of issue
Mar 2012

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Petroianu A. Síntese de grandes feridas da parede corpórea com tira elástica de borracha. ABCD Arq Bras Cir Dig 2010;23:16-18.

[2] 2. Campbell AM, Kuhn WP, Barker P. Vacuum-assisted closure of the open abdomen in a resource-limited setting. S Afr J Surg 2010;48:114-115.

[3] 3. Cothren CC, Moore EE, Johnson JL, Moore JB, Burch JM. One hundred percent fascial approximation with sequential abdominal closure of the open abdomen. Am J Surg 2006;192:238-242.

[4] 4. Navsaria PH, Bunting M, Omoshoro-Jones J, Nicol AJ, Kahn D. Temporary closure of open abdominal wounds by the modified sandwich-vacuum pack technique. Br J Surg 2003;90:718-722.

[5] 5. Hilliard ST, Chew KY, Chung AY, Tan B. Improving vacuum-assisted closure of widely open abdomens with improvised elastic sutures. Eur J Plast Surg 2011; [Article in Press]

[6] 6. Björck M, Bruhin A, Cheatham M, Hinck D, Kaplan M, Manca G, Wild T, Windsor A. Classification-important step to improve management of patients with an open abdomen. World J Surg 2009;33:1154-1157.

[7] 7. van As AB, Navsaria P, Numanoglu A, McCulloch M. Modified sandwich vacuum pack technique for temporary closure of abdominal wounds: an African perspective. Acta Clin Belg Suppl 2007;(1):215-219.

[8] 8. Petroianu A. Opção técnica para a síntese de grandes feridas da parede corpórea. Rev Col Bras Cir 2009;36:353-355.

[9] 9. Petroianu A. Closure of large wounds of the body wall with elastic rubber strip. Am Surg 2010;76:E168-169.

[10] 10. Petroianu A. Synthesis of large wounds of the body wall with rubber elastic band. Acta Med Port 2011;24:427-430.

[11] 11. Durani P, McGrouther DA, Ferguson MW. Current scales for assessing human scarring: a review. J Plast Reconstr Aesthet Surg 2009;62:713-720.

[12] 12. Verhaegen PD, van der Wal MB, Middelkoop E, van Zuijlen PP. Objective scar assessment tools: a clinimetric appraisal. Plast Reconstr Surg 2011;127:1561-1570.

[13] 13. Vidigal FM, Petroianu A. Avaliação de cicatrizes cutâneas: apresentação de um método quantitativo. Rev Col Bras Cir 2010;37:121-127.

[14] 14. Barkun JS, Aronson JK, Feldman LS, Maddern GJ, Strasberg SM; Balliol Collaboration, Altman DG, Barkun JS, Blazeby JM, Boutron IC, Campbell WB, Clavien PA, Cook JA, Ergina PL, Flum DR, Glasziou P, Marshall JC, McCulloch P, Nicholl J, Reeves BC, Seiler CM, Meakins JL, Ashby D, Black N, Bunker J, Burton M, Campbell M, Chalkidou K, Chalmers I, de Leval M, Deeks J, Grant A, Gray M, Greenhalgh R, Jenicek M, Kehoe S, Lilford R, Littlejohns P, Loke Y, Madhock R, McPherson K, Rothwell P, Summerskill B, Taggart D, Tekkis P, Thompson M, Treasure T, Trohler U, Vandenbroucke J. Evaluation and stages of surgical innovations. Lancet 2009;374:1089-1096.

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Some considerations on "synthesis of large wounds of the body wall with rubber elastic band"

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