Hernia Research Today is a free monthly online journal that collates and summarizes the latest research about Hernia, including details on hiatal, inguinal, umbilical, abdominal, treatment.

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

Fantus RJ, Mellett MM, Kirby JP

Section of Trauma and Critical Care, Department of Surgery, Advocate Illinois Masonic Medical Center, Trauma Office, Chicago, 60657, USA. richard.fantus@advocatehealth.com

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.

Published 24 July 2006 in Am J Surg, 192(2): 243-7.
Full-text of this article is available online (may require subscription).

© 2004-2008 Hernia Research Today. All Rights Reserved.