Families and Loved Ones

What is the STAR Procedure?

In order to treat you or your loved one your surgeon is using a technique known as staged abdominal repair or STAR. Because of the severe illness of your loved one, he or she may not tolerate the length or complexity of the operation that is really needed to address all of the surgical issues. STAR is often the best way to avoid complications and assure the best outcome possible. Sometimes the STAR procedure is used because the infection is so severe that antibiotics alone can't cure it.

The STAR procedure is not simply one operation. It is one operation that is done in multiple steps over several days, up to a week or longer. You should expect your loved one to be in the intensive care unit during this time. He or she will be attached to many monitors, IV drips and a breathing machine. These all support your loved one's bodily functions while he or she heals with your surgeon's and nurses' help. During this time your loved one will receive medications for pain and sedation so that he or she is not in pain or anxious. Your surgeon may need to temporarily give muscle relaxant medication which will prevent your loved one from moving. He/she will be taken to the operating room daily or every other day. Some days the surgeon may simply clean out the abdominal cavity of infection and other days the surgeon may fix specific problems.

What is the Bur Hypopack?

Bur Hypopack

The STAR procedure heavily depends on two velcro like sheaths (a device called the Bur Patch) being implanted in your loved one's abdominal wall. These will allow the surgeon to easily open and close the abdomen every day without having to use a scalpel to open the abdomen every time. Often times the infection in the abdomen is so severe that the organs and bowel swell up, not unlike a finger you may have injured. These swollen organs sometimes make it difficult to close the abdominal wall, similar to a pair of pants that's too tight after a big meal. The overlapping velcro will allow the surgeon to adjust the pressure appropriate for your loved one's current medical situation. Over time the swelling will go down, the velcro will overlap more and more until finally the abdominal wall can be closed. This will signify the last STAR procedure.

Because the velcro sheaths are not air tight, the wound will be covered by gauze and a clear dressing. This wound dressing when used together with the Bur Patch is known as the Bur Hypopack. A drain tube will come out from underneath the dressing to extract fluid from the abdominal cavity. This wound dressing will provide a sterile barrier against new infections. You should expect to see a clear or yellow plastic barrier covering your loved ones abdomen. It will appear hard and sucked down onto the gauze dressing underneath. The suction is by design and removes unwanted fluid from the abdomen.

After the final STAR procedure, you should expect you loved on to stay in the intensive care unit for a few more days at the discretion of the surgeon.

At openabdomen.org, we are dedicated to support your surgeon in the care of your loved one through continued education and research. If you'd like to print out this information you can click on Family Brochure at the top of this page. You can also email this information using the Information For Families icon in the website header.

If you should have any further questions, please ask your surgeon or you may reach us though this contact link.

Sincerely,

The team at openabdomen.org.