The Wittmann Patch™ as a temporary abdominal closure device after decompressive celiotomy for abdominal compartment syndrome following burn

Keramati, Magid; Srivastava, A. K.; Sakabu, Stanley A.; Rumbolo, Peter M.; Smock, Michael; Pollack, Jonathon; Troop, Bryan

doi:10.1016/j.burns.2007.06.024

Cited by 38 publications

(26 citation statements)

References 27 publications

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“…Patients with incisional hernias achieved delayed abdominal closure after 15 (3-62) days and 4 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16) reoperations. Patients without incisional hernias had significantly fewer treatment days (6 (3-28)) as well as less reoperations (3 (1-14)) (p \ 0.005).…”

Section: Discussionmentioning

confidence: 99%

“…Different techniques of temporary closure during OA treatment have been described and include Marlex Ò zippers, plastic bags (Botoga technique), sandwich technique, and others [1][2][3][4][5]. The introduction of negative pressure wound therapy (NPWT) in the open abdomen after acute surgery could significantly decrease morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

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Delayed closure of open abdomen in septic patients treated with negative pressure wound therapy and dynamic fascial suture: the long-term follow-up study

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Delayed closure of open abdomen in septic patients treated with negative pressure wound therapy and dynamic fascial suture: the long-term follow-up study

et al. 2017

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“…In addition, several types of extracellular matrix-derived biological implants have been used [26,27] , although they are not recommended to bridge a fascial defect, and the long-term durability and functional outcome of biological implants is still unknown [28] . Other techniques for progressive closure of the abdominal wall, in combination or not with NPWT, include dynamic wound closure systems based on continuous dynamic tension to achieve re-approximation of the fascial edges of the abdominal wall [29,30] or the use of patches of synthetic material as a temporary, gradual means for abdominal closure [31] ; (3) Patients beyond the 2-3 wk window without progress towards closure or improvement of general condition and interstitial edema ("frozen abdomen") and without bowel fistulization. In these cases, the treatment options include skin cover over the defect or allow wound granulation (absorbable synthetic mesh implant, NPWT) and thereafter cover with skin grafts and subsequent definitive delayed closure (after 6-12 mo) in the context of a "planned" incisional hernia repair [32][33][34][35][36][37] ; and (4) Patients with enteroatmospheric fistula.…”

Section: Treatment Optionsmentioning

confidence: 99%

“Acute postoperative open abdominal wall”: Nosological concept and treatment implications

López-Cano

Pereira

Armengol

2013

WJGS

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The so-called "burst abdomen" has been described for many years and is a well-known clinical condition, whereas the concept of the "open abdomen" is relatively new. In clinical practice, both nosological entities are characterized by a complex spectrum of symptoms apparently disconnected, which in many cases poses a great challenge for surgical repair. In order to assess the management of these disorders in a more comprehensive and integral fashion, the concept of "acute postoperative open abdominal wall" (acute POAW) is presented, which in turn can be divided into "intentional" or planned acute POAW and "unintentional" or unplanned POAW. The understanding of the acute POAW as a single clinical process not only allows a better optimization of the therapeutic approach in the surgical repair of abdominal wallrelated disorders, but also the stratification and collection of data in different patient subsets, favoring a better knowledge of the wide spectrum of conditions involved in the surgical reconstruction of the abdominal wall.

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“…However, in some cases, the surgeon is forced to leave the open abdomen tactic that is associated with a mortality rate of 30% [1][2][3] . The open abdomen technique (AA) is a surgical strategy used in patients with related life-threatening intraabdominal hemorrhage, prevention or treatment of intraabdominal hypertension and treatment of intra-abdominal sepsis.…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

Open abdomen management: single institution experience

Rodrigues

Novo

Arouca

et al. 2015

Rev. Col. Bras. Cir.

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. Today, despite advances in AA use with the development of vacuum therapy, the Bogota Stock Exchange (BB) is still widely used. In our institution and throughout Brazil, both techniques are used and the study's goal is to evaluate the morbidity and the result of the integrity of the abdominal wall after the use of both techniques. METHODS METHODS METHODS METHODS METHODSA retrospective study was conducted at HCFMUSP, identifying patients undergoing temporary abdominal closure (FAT) between January 2005 and December 2011. Data were collected through review of medical records. Data were compared in patients undergoing treatment with assisted closing the vacuum and the Bogota bag.Inclusion criteria were temporary abdominal closure indication survival and the definitive abdominal closure. FAT indications included: abdominal trauma, severe abdominal sepsis and ACS. Data collected included age, FAT indication, the number of procedures in the operating room and the primary fascial closure rate. In the postoperative period, one group of three surgeons followed all patients and performed all reoperations. As soon as possible, the aponeurosis of the edges were subjected to progressive approach with careful not to cause abdominal hypertension.The demographics of the two study groups (BB and VAC) were compared using the chi-square test of Pearson or Fisher's exact test for categorical variables and the Student t test for continuous variables. RESULTS RESULTS RESULTS RESULTS RESULTSDuring the study period, 59 patients require some kind of temporary abdominal closure (FAT), however, only 29 patients survived the final abdominal closure (52.5% mortality). One patient was excluded (subject to closure Backaus forceps). Thus, 28 patients were included, and, after two years of follow-up, none of them developed abdominal hernia or intestinal fistulas.There was no statistical difference between the study groups with respect to age (p> 0.05) and a significant difference regarding indications for temporary abdominal closure (p <0.05) ( Table 1).The primary closure rates were similar in both groups (p = 0.98). The average time (days) for fascial closure was 10.8 days for the BB group and 7.52 days in the group VAC (Table 2). DISCUSSION DISCUSSION DISCUSSION DISCUSSION DISCUSSIONIn this study, there was no statistical difference between the closing assisted vacuum and the Bogota bag (VAC and BB) when analyzed the number of operations, the primary closure, and the average time of closing. However, a previous study 19 showed better results when using VAC BB was compared on the primary closure (50 to 70 %% and 88% for BB VAC). The best approach to achieve the definitive abdominal closure in patients with open abdomen remains controversial. To improve the fascial closure rate, the excess volume resuscitation should be avoided, the water balance should be carefully implemented, not only on admission, but also throughout the course of treatment with open abdomen 20 . The high rate of primary closure found in our patients, 80% for BB and 96% f...

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The Wittmann Patch™ as a temporary abdominal closure device after decompressive celiotomy for abdominal compartment syndrome following burn

Cited by 38 publications

References 27 publications

Delayed closure of open abdomen in septic patients treated with negative pressure wound therapy and dynamic fascial suture: the long-term follow-up study

Delayed closure of open abdomen in septic patients treated with negative pressure wound therapy and dynamic fascial suture: the long-term follow-up study

“Acute postoperative open abdominal wall”: Nosological concept and treatment implications

Open abdomen management: single institution experience

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