What is Smead Jones closure?

What is Smead Jones closure?

Mass closure of abdominal incisions. (A) Smead-Jones closure. Far-far-near-near. Suture passes laterally through rectus sheath and peritoneum and adjacent fat. The suture crosses midline to pick up medial edge of fascia on opposite side of incision.

What is a staged abdominal closure?

Background. The Philadelphia Technique is a staged approach to closure of an ‘unclosable’ open abdomen, which is typically the result of a catastrophic intra-abdominal event.

What operative method is used for revision of abdominal cavity in cases of abdominal injuries?

Laparotomy, also known as celiotomy, is performed by making a large incision in the abdomen to gain access to the peritoneal cavity. A standard laparotomy usually involves a sagittal, midline incision along the linea alba.

What is mass closure?

Mass closure is continuous fascial closure with a single suture. This method allows even distribution of tension across the entire length of the suture, resulting in minimization of tissue strangulation. The goal is approximation of tissue edges to allow scar formation.

What is fascial closure?

Fascial closure is the closure of the inner layers of the abdomen after a major surgery involving an incision on the abdomen. Fascial closure prevents hernia formation. The fascial closure technique is of two types: layered closure and mass closure.

What is the CPT code for exploratory laparotomy?

An exploratory laparotomy (CPT code 49000) is not separately reportable with an open abdominal procedure.

What is mass closure technique?

How do you close an open abdominal wound?

Temporary abdominal wall closure can be achieved by placing an absorbable mesh or plastic visceral retainer and packing the resultant wound with gauze with or without retention sutures. The fascia then retracts laterally, and loss of abdominal domain begins.

What type of suture is used to close the peritoneum?

Closure of the parietal peritoneum is usually performed using absorbable (dissolved by body fluids) or delayed absorbable sutures, and can be done with interrupted or continuous sutures.

What suture is used to close the fascia?

Nonabsorbable sutures are used in fascial closure. The surgeon pulls apart the fascial layer with two clamps. A looped synthetic material known as polydioxanone (PDS) is used for suturing.

What is the difference between CPT 49000 and 49010?

Open exploration of the abdomen through a midline or subcostal incision is described by CPT code 49000 (Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure)) while open retroperitoneal exposure requires CPT code 49010 (Exploration, retroperitoneal area with or without biopsy(s) ( …

What is the CPT code for abdominal washout?

Ab wash out code You can use code 49084.

How do you close a laparotomy?

Recent research on prevention of incisional hernia formation suggests that a laparotomy closure technique using a slowly absorbable monofilament suture with small fascial steps and bites in a continuous, single layer with a suture length to wound length (SL/WL) ratio of at least 4:1 is effective in lowering morbidity.