Early aggressive closure of the open abdomen

Bradford G. Scott, Francis J. Welsh, Hoang Q. Pham, Matthew M. Carrick, Kathleen R. Liscum, Thomas S. Granchi, Matthew J. Wall, Kenneth L. Mattox, Asher Hirshberg, C. William Schwab

Research output: Contribution to journalReview articlepeer-review

84 Scopus citations


Background: The aim of this series is to describe a new and aggressive approach to definitive closure of the open abdomen. Methods: A retrospective review of 37 patients who underwent definitive abdominal closure using a combination of vacuum pack, vacuum-assisted wound management and human acellular dermal matrix (HADM). Results: All patients' open abdomens were maintained with vacuum assisted wound management in attempts for primary closure. Once it was determined that the abdomen would not close primarily; it was closed with HADM and skin advancement. The mean duration of the open abdomen was 21.7 days (range 6-45), with an average of 127.78 cm2 of HADM, the largest number being 800 cm2, with decreasing use of product later in the series. No major complications were seen with the repair. Superficial wound infection occurred with two patients that were easily treated with wet to dry dressing changes. No intraabdominal complications such as fistula or graft loss were seen. All patients left the hospital with an intact abdominal wall and skin. All 37 patients survived to discharge and were seen in follow-up within one month. No early hernia formation was seen at the one month follow up with the longest at three years. No abdominal wall complications were seen in subsequent follow up patients. Conclusions: Early aggressive closure of the open abdomen is possible with a combination of vacuum pack, vacuum-assisted wound management and HADM. Short term results are promising and warrant further study.

Original languageEnglish (US)
Pages (from-to)17-22
Number of pages6
JournalJournal of Trauma - Injury, Infection and Critical Care
Issue number1
StatePublished - Jan 2006
Externally publishedYes


  • Human acellular dermal matrix
  • Open abdomen
  • Trauma

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine


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