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The Omentum is Your Friend
|Omental wrapping can be used after an enterotomy or an enterectomy. A rubber toy was found in the jejunum of the patient, a 1-year-old male collie. Courtesy of Dr. Phil Zeltzman|
In the Abdomen
The omentum is mostly used in the abdominal cavity.
- After a gastrotomy, the omentum can be loosely sutured near the incision, effectively creating an omentopexy.
- After an enterotomy or enterectomy, the intestine can be wrapped in omentum. Sutures are not even necessary. Omental wrapping, or augmentation, should be done after lavage has been performed.
- Similarly, the bladder can be covered with omentum after a cystotomy.
Used in this fashion, the omentum promotes vascularization. It brings fibroblasts to the surgical site and enhances healing.
The omentum also can help reconstruct the abdominal wall. For example, it can be used between nylon mesh and the skin.
The omentum may contain and fight septic peritonitis. It can be used to control mild hemorrhage from the liver or the spleen, as it has hemostatic properties.
It can be beneficial to wrap feeding tubes (gastrostomy and enterostomy), as well as cystostomy tubes, with omentum to provide a seal.
It is vital, however, not to consider the omentum a substitute for appropriate suturing or ligating technique. Likewise, i...
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