Early application of abdominal re-approximation anchor system for the management of the open abdomen

Abstract

Abstract Managing open abdomens in critically ill patients after damage control surgery is complex and challenging. Delay in definitive surgery reduces successful primary fascial closure increasing complications. Early abdominal wall closure can improve patient outcomes and reduce risks. We retrospectively reviewed all patients who had the abdominal re-approximation anchor applied to achieve primary fascial closure at our institution. The electronic health record was reviewed for demographics, open abdomen indication, total number of operations, time to primary closure, success rate of primary fascial closure, and complications related to the use of the system. Between May 2015 and May 2018, we applied the abdominal re-approximation anchor system to 7 patients managed with open abdomens. Intra-peritoneal sepsis was the indication in 4 patients while the rest were secondary to trauma. The system was applied after an average of 4.7 ± 1.9 days. The fascia was retracted an average of 19 ± 1.5 cm. Tension free fascial closure was achieved in all patients after an average of 5.4 ± 2 days. Early application of the abdominal re-approximation anchor system was associated with achieving tension free delayed primary fascia closure in all our patients with no major abdominal complications.