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INDICATIONS FOR STAR

Staged Abdominal Repair

Staged abdominal repair (STAR) is a conceptual operative approach combining the advantages of planned relaparotomy and of open management with a minimal rate of complications. It has been sucessfully used in conditions and diseaes listed below.


General Use & Indication: THE PLANNED OPEN ABDOMEN


  • Critical patient's condition (hemodynamic instability) precluding definitive repair
  • Excessive peritoneal edema: preventing abdominal closure without undue tension
  • Abdominal compartment syndrome
    with
  • Pulmonary dysfunction
  • Cardiac impairment
  • Renal insufficiency
  • hepatic dysfunction,
  • decreased visceral perfusion)
  • Massive abdominal wall loss
  • Impossibility to eliminate or to control the source of infection
  • Incomplete debridement of necrotic tissue
  • Uncertainty of viability of remaining bowel


    • B) SPECIFIC: Indications to treat specific conditions


  • Severe Abdominal Trauma
  • Major Hemorrhage Requiring Packing
  • Excessive Intra-abdominal Edema
  • Diffuse Suppurative Peritonitis
  • Increased intra-abdominal pressure
  • Conditions with progressive deterioration
  • Inability to perform definitive repair
  • Inability to to eliminate the source of infection
  • Inability to debride dead tissue sufficiently
  • Multiple previous operations
  • Infected Pancreatic Necrosis
  • Bowel Ischemia
  • Ruptured Aortic Aneurysm


    • Benefits of Bur Closure

  • Bridges fascial gap
  • No evisceration, no fistula
  • Decreases intra-abdominal pressure
  • Improves renal and hepatic function
  • Improves pulmonary & cardiac function
  • Improves intra-abdominal perfusion
  • Improves intra-abdominal perfusion
  • Adjuast in size to change of abdomnal girth
  • Rapid abdominal entry and re-entry
  • fdinal fascia-to-fascia closure