An Update in the Management of “Frozen Abdomen”

Abstract

With a 0.5–3% incidence following initial closure of a laparotomy incision, wound dehiscence is a significant postoperative complication that signifies an abrupt mechanical failure of wound healing. Both clinical entities have common pathophysiological and clinical processes, as recently as the idea of "intentional open abdomen" was defined ("postoperative open abdominal wall"). While early restoration is the goal, a considerable number of patients may experience adhesions between the anterolateral abdominal wall and abdominal viscera; this condition is commonly referred to as "frozen abdomen," and the only practical option seems to be to postpone wound closure. We provide the "Coliseum technique" as the last surgical approach to treat it. This new method offers a creative substitute for abdominal exploration in situations with frozen abdomen that is considered "malignant" because of peritoneal carcinomatosis. Lifting the surgical wound's edges upward and suspending them from a retractor above the abdomen with threads makes it easier to approach the peritoneal cavity, maximizes the exposure of internal organs, and reduces the risk of operating-related damage to the blood supply and innervation of the abdominal wall muscles, which is an essential step for hernia repair later on..