Dynamic wound closure system and open abdomen, safety and efficacy

Introduction: Damage-control surgery is abbreviated surgery performed to control a patient’s life-threatening illness. It minimizes the time during which the patient is exposed to coagulopathic stimuli, hypothermia and acidosis in the operating room in favour of returning the patient to the intensive care unit as expeditiously as possible for a full resuscitation. Aim: Evaluation of efficacy and safety of dynamic wound closure system in open abdomen Methods: Between March 2018 and March 2019, 12 patients with severe peritonitis and abdominal trauma were stabilized by laparotomy and the developed open abdomen was treated by dynamic wound closure (ABRA SYSTEM) after a variable period of ICU admission with strict following of the protocol of damage control surgery (DCS). Results: The mean duration ICU admission before ABRA application was 5 days. The mean duration of ABRA application was 15days. The average width of the abdominal defect was 15 cm. The average length of defect was 20 cm. Delayed primary abdominal closure was accomplished in 8 patients without further surgery. Incisional hernia with a small abdominal defect developed in 2 patients. Skin graft was applied over wide defect in 2 patients. Conclusion: Abdominal re-approximation by dynamic wound closure system is safe and effective, however it is very pain full and needs more analgesic support.