BACKGROUND: Although the 'open abdomen' has likely contributed to improved outcomes in trauma patients, the challenge of subsequent fascial closure has emerged. Since mid 2004, we have incorporated Wittmann Patch staged abdominal closure into our management of the open abdomen. The purpose of this study was to evaluate the impact of this device on our incidence of fascial closure versus planned ventral hernia. METHODS: Patients managed by open abdomen from 2001 through 2006 were identified from the trauma registry. Fascial closure immediately after definitive repair of injuries was defined as 'early fascial closure.' Inuyasha final act english dub torrent download.

Continuation of the open abdomen beyond the definitive repair of injuries with subsequent fascial closure was defined as 'delayed fascial closure.' Since April 2004, the Wittmann Patch was uniformly employed in open abdomen management. Patients managed before the use of this device ('pre-Patch') were compared with those managed in the 'Patch' era. Relux tunnel crack.

Wittmann Patch. The Wittmann Patch (STARSURGICAL, Inc., Burlington, WI) was designed to allow adjustment in the laxity or redundancy of the closure material to accommodate changes in intra-abdominal pressure and prevent abdominal compartment syndrome. Wittmann Patch. The Wittmann Patch is a Velcro ®-like device for bridging and re-approximating abdominal wall openings where primary closure is not possible and/or repeat abdominal entries are necessary. The Wittmann Patch is often used with open abdomen negative pressure treatment when negative pressure treatment alone isn't enough to achieve fascia-to-fascia closure.

RESULTS: Fifty-six open abdomens were managed in the pre-Patch era and 103 were managed in the Patch era. In the pre-Patch era, 33 (59%) underwent early fascial closure, compared with 67 (65%) in the Patch era (p NS). For the remaining patients, the incidence of delayed fascial closure was significantly higher in those managed with the Wittmann Patch compared with those managed in the pre-Patch era (78% vs.