Development of a novel method of progressive temporary abdominal closure.
BACKGROUND
This paper describes our experience with a novel method of temporary abdominal closure that permits frequent reassessment of the abdominal contents and progressive reapproximation of the fascial edges without compromising definitive fascial closure outcomes.


METHODS
We developed a novel method of temporary abdominal closure, which we have named the frequent assessment temporary abdominal closure (FASTAC). The records of patients who underwent planned relaparotomy during 5 years were reviewed. The data collected included patient demographics, indication for operation, number of operations, duration of temporary abdominal closure placement, hospital duration of stay, method of definitive abdominal closure, and subsequent ventral hernia repair.


RESULTS
One hundred and thirty-three patients underwent 308 temporary abdominal closure placements, including 16 patients who had a FASTAC placed for open abdomen management. FASTAC remained in place for a significantly greater time with more frequent reassessment. Fascial closure techniques were not different in FASTAC patients. FASTAC patients had a significantly greater duration of stay, which suggests selective placement in a more complicated patient population. The materials for frequent assessment temporary abdominal closure cost only $38 compared with $350 for a large piece of Silastic.


CONCLUSIONS
FASTAC is a novel, cost-effective method of temporary abdominal closure that allows for frequent bedside intra-abdominal surveillance, maintains abdominal domain, and does not compromise abdominal closure outcomes in the management of the open abdomen.
Goodman
Michael D
MD
Department of Surgery, Division of Trauma and Critical Care, University of Cincinnati, Cincinnati, OH 45267, USA. goodmamd@uc.edu
Pritts
Timothy A
TA
Tsuei
Betty J
BJ
D000005:Abdomen / Q000601:surgery; D000007:Abdominal Injuries / Q000601:surgery*; D034861:Abdominal Wall / Q000601:surgery*; D001672:Biocompatible Materials; D003362:Cost-Benefit Analysis; D000071938:Fasciotomy; D006801:Humans; D007813:Laparotomy / Q000191:economics; D054843:Negative-Pressure Wound Therapy; D012086:Reoperation; D012189:Retrospective Studies; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome
D001672:Biocompatible Materials