Esmarch closure of laparotomy incisions in unstable trauma patients

Fascial closure after laparotomy may be time-consuming and extremely difficult, especially in the setting of massive bowel edema. In the trauma patient with deteriorating hemodynamic status, hypothermia, or worsening hypoxia, expeditious abdominal wall closure is essential to facilitate rapid transport to the intensive care unit for further stabilization. With the increasing utilization of the abbreviated laparotomy in unstable trauma patients, innovative techniques for speedy fascial closure must be evaluated. We developed the Esmarch closure--a simple, rapid method for closing the abdominal wall at the end of abbreviated laparotomies.