The Wittmann Patch s a temporary abdominal closure device after decompressive celiotomy for abdominal compartment syndrome following burn.
BACKGROUND
Abdominal compartment syndrome is frequently the result of aggressive fluid resuscitation after burn. Management of the open abdomen following decompressive celiotomy is a major problem.


METHODS
From 2004 to mid-2005, six patients required decompressive celiotomy after developing abdominal compartment syndrome as a result of burn. A Wittmann Patch as used to close the abdominal wound. Patients were re-explored when clinical parameters improved and the abdomen was closed, with long-term follow-up for the abdominal wound.


RESULTS
Of the six patients, five had thermal injury and one had electrical injury. The mean total body surface area affected for thermal burn was 78% and for electrical burn was 37%. Diagnosis of abdominal compartment syndrome was based on elevated bladder pressure and organ dysfunction. The patients were treated with decompressive celiotomy and Wittmann Patch closure. Survivors subsequently underwent primary abdominal closure, with no evidence of ventral hernia at long-term follow-up.


CONCLUSIONS
In burn cases with abdominal compartment syndrome, a Wittmann Patch ay prove a helpful method of temporary abdominal closure, followed by primary closure with no complications.
Keramati
Magid
M
Department of Surgery, St. Louis University Hospital, St. Louis, MO, USA.
Srivastava
Anil
A
Sakabu
Stanley
S
Rumbolo
Peter
P
Smock
Michael
M
Pollack
Jonathon
J
Troop
Bryan
B
D000005:Abdomen; D000328:Adult; D001672:Biocompatible Materials / Q000627:therapeutic use*; D002056:Burns / Q000150:complications / Q000601:surgery*; D003161:Compartment Syndromes / Q000209:etiology / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D005440:Fluid Therapy / Q000009:adverse effects; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome; D055815:Young Adult
D001672:Biocompatible Materials