Use of controlled fascial tension and an adhesion preventing barrier to achieve delayed primary fascial closure in patients managed with an open abdomen

Richard J. Fantus, Michele M. Mellett, John P. Kirby

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

Open management of the abdomen has become an accepted technique for both the treatment and the prevention of abdominal compartment syndrome. It has also gained popularity as a treatment option in situations requiring multiple laparotomies such as uncontrolled intra-abdominal infections and severe abdominal injury necessitating damage control surgery. A significant number of patients managed with the open abdomen technique are unable to undergo complete abdominal wall closure and consequently develop large, complex anterior abdominal wall hernias. We report the use of a controlled fascial tensioning device, the Wittmann Patch (Starsurgical, Inc, Burlington, WI), in combination with an adhesion preventing barrier to allow for unhindered sequential medial advancement of the fascia toward the midline. The use of these 2 devices together may lead to a higher incidence of fascia-to-fascia abdominal wall closure than the use of fascial tension alone.

Original languageEnglish
Pages (from-to)243-247
Number of pages5
JournalAmerican journal of surgery
Volume192
Issue number2
DOIs
StatePublished - Aug 2006

Keywords

  • Adhesions
  • Fascial advancement
  • Open abdomen
  • Sterile x-ray cassette cover
  • Wittmann Patch

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