Delayed primary closure in damage control laparotomy: the value of the Wittmann patch
Josef G Hadeed1, Gregory W Staman, Hector S Sariol
1Department of Surgery, Cooper University Hospital, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Camden, New Jersey, USA.
The American Surgeon
|January 26, 2007
Summary
The Wittmann patch facilitates staged abdominal closure in trauma surgery, achieving an 83% delayed primary closure rate. This method offers a viable option for managing abdominal compartment syndrome and severe abdominal trauma.
Area of Science:
- Trauma Surgery
- Surgical Innovation
Background:
- Damage control laparotomy is standard in trauma care.
- Various methods for delayed primary abdominal closure exist, each with potential complications.
Purpose of the Study:
- To evaluate the efficacy of the Wittmann patch for staged abdominal closure.
- To determine the rate of delayed primary closure using the Wittmann patch.
Main Methods:
- The Wittmann patch, a temporary abdominal closure device, was used in 26 patients.
- Patients underwent staged abdominal closure with planned relaparotomy.
- The patch allows for bedside advancement and exploration.
Main Results:
- Eighty-three percent (20 of 24) of patients achieved delayed primary closure.
- The average time to closure was 13.1 days after patch placement.
- The Wittmann patch demonstrated a closure rate comparable to other methods.
Conclusions:
- The Wittmann patch is an effective method for staged abdominal closure.
- It offers advantages in managing abdominal compartment syndrome and severe abdominal trauma.
- This technique minimizes complications associated with delayed abdominal closure.
