Case Report: Delayed Primary Wound Closure After Extensive Abdominal Wall Resection for Infection and Malignancy Using TopClosure®

Abstract

The closure of a massive abdominal wall defect is illustrated using a novel dynamic closure technique - the TopClosure® tension relief system. This system attaches to the abdominal wall immediately after laparotomy and allows for early approximation of the skin, avoiding an open abdomen and the complications associated with this. The technique in this case was employed after extensive resection of the abdominal wall for infected skin metastases of colonic adenocarcinoma and circumvented post-operative ventilation and open abdomen. Early recovery after such extensive surgery is important in terms of patient morbidity and mortality. In this case, primary surgery may not have been an acceptable risk to undertake without the option of Top Closure of the abdomen. We illustrate the technique of abdominal wall closure through a series of images of the procedure.

Israeli Innovations in the Field of Plastic Surgery

“…7). 38,40,45 TopClosure TRS and negative pressure therapy have been utilized with demonstrable success across a variety of anatomical locations and for a diverse set of clinical presentations. Since its index study, TopClosure has been successfully used to manage congenital nevi, traumatic hemipelvectomy, bladder extrophy, enteroatmospheric fistula, and extensive abdominal wall defect following malignancy resection.…”

“…Since its index study, TopClosure has been successfully used to manage congenital nevi, traumatic hemipelvectomy, bladder extrophy, enteroatmospheric fistula, and extensive abdominal wall defect following malignancy resection. 35,37,40,43,[45][46][47] Topaz has presented numerous studies in the literature reporting on its positive outcomes for managing medium and large soft tissue defects with a low posttreatment complication profile. 35,36,38,47 Supplementing management with oxygen therapy has proven to be effective and may also reduce the risk of anaerobic bacterial contamination and mitigate risk of infection.…”