title: Management of the open abdomen using combination therapy with ABRA and ABThera systems.
abstract: BACKGROUND
  The open abdomen is an increasingly used technique that is applied in a wide variety of clinical situations. The ABThera Open Abdomen Negative Pressure Therapy System is one of the most common and successful temporary closure systems, but it has limited ability to close the fascia in approximately 30% of patients. The abdominal reapproximation anchor system (ABRA) is a dynamic closure system that seems ideal to manage patients who may not achieve primary fascial closure with ABThera alone. We report on the use of the ABRA in conjunction with the ABThera in patients with an open abdomen.
  
  
  METHODS
  We retrospectively analyzed patients with an open abdomen managed with the ABThera and ABRA between January 2007 and December 2012 at the Halifax Infirmary, QEII Health Science Centre, Halifax, Nova Scotia.
  
  
  RESULTS
  Sixteen patients had combination therapy using the ABRA and ABThera systems for treatment of the open abdomen. After removing patients who died prior to closure, primary fascial closure was achieved in 12 of 13 patients (92%).
  
  
  CONCLUSIONS
  We observed a high rate of primary fascial closure in patients with an open abdomen managed with the ABThera system in conjuction with the ABRA. Applying mechanical traction in addition to the ABThera should be considered in patients predicted to be at high risk for failure to achieve primary fascial closure.
authors.affiliation: Dalhousie University, Halifax, NS.
authors.forename: Alfin N
authors.initials: AN
authors.lastname: Mukhi
authors.affiliation: Dalhousie University, Halifax, NS.
authors.forename: Samuel
authors.initials: S
authors.lastname: Minor
mesh_terms: D058107:Abdominal Wound Closure Techniques / Q000295:instrumentation*; D000328:Adult; D000368:Aged; D004867:Equipment Design; D000071938:Fasciotomy; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000401:mortality / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000295:instrumentation*; D009674:Nova Scotia / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D014945:Wound Healing