A new procedure for abdominal wound closure after pediatric liver transplantation: the "sandwich" technique

Primary wound closure cannot always be achieved after pediatric liver transplantation (LTx). This may be due to lack of intraabdominal space from postanhepatic small bowel edema or oversized grafts despite partial LTx. For those instances we developed the "sandwich" technique. This procedure incorporates advantages of previous techniques with some additional advantages described herein. Use of polyglactin 910/silicone meshs in a sandwich fashion allows for one-stage permanent abdominal closure without major loss of body plasma fluids after pediatric LTx. So far our clinical experience with this technique has been very satisfying.