Open and semiopen management

The open and semi-open techniques are based on primary surgical necrosectomy and frequent planned reoperations. After initial debridement, the involved necrotic area is packed with a ring of non-adherent gauze, the abdomen is left open, and the packing is changed every 24 to 48 h under sedation in the ICU. Other centers have introduced a semi-open procedure by inserting a synthetic mesh or a zipper in the abdominal fascia to allow easy re-entry for repeated lavage. Experienced centers have been able to reduce mortality rates to a favorable 15 per cent in patients with necrotizing pancreatitis. However, the schedule of repeated intra-abdominal manipulation results in a high incidence of bowel complications, pancreatic fistulas, and hemorrhage. Consequently, surgical treatment and the need for ICU therapy is often mandatory for several weeks.

Sleep Apnea

Sleep Apnea

Have You Been Told Over And Over Again That You Snore A Lot, But You Choose To Ignore It? Have you been experiencing lack of sleep at night and find yourself waking up in the wee hours of the morning to find yourself gasping for air?

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