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Open Access 01-12-2019 | Laparotomy | Research article

A new device to prevent fascial retraction in the open abdomen – proof of concept in vivo

Authors: Roman Eickhoff, Maria Guschlbauer, Alexandra C. Maul, Christian D. Klink, Ulf P. Neumann, Michael Engel, Martin Hellmich, Anja Sterner-Kock, Christian F. Krieglstein

Published in: BMC Surgery | Issue 1/2019

Abstract

Background

An open abdomen is often necessary for survival of patients after peritonitis, compartment syndrome, or in damage control surgery. However, abdominal wall retraction relieves delays and complicates abdominal wall closure. The principle of the newly fascia preserving device (FPD) is the application of anteriorly directed traction on both fascial edges over an external support through a longitudinal beam to relieve increased abdominal pressure and prevent fascial retraction.

Methods

Twelve pigs were randomly divided into two groups. Both groups underwent midline laparotomy under general anesthesia. Group one was treated with the new device, group two served as controls. The tension for closing the abdominal fascia was measured immediately after laparotomy as well as at 24 and 48 h. Vital parameters and ventilation pressure were recorded. Post mortem, all fascial tissues were histologically examined.

Results

All pigs demonstrated increases in abdominal circumference. In both groups, forces for closing the abdomen increased over the observation period. Concerning the central closing force after 24 h we saw a significant lower force in the FPD group (14.4 ± 3 N) vs. control group (21.6 ± 5.7 N, p < 0.001). By testing the main effects using an ANOVA analysis we found a significant group related effect concerning closing force and abdominal circumference of the FDP-group vs. control group (p < 0.001; p < 0.001). The placement of the device on chest and pelvis did not influence vital parameters and ventilation pressure. Histologic exam detected no tissue damage.

Conclusions

This trial shows the feasibility to prevent fascial retraction during the open abdomen by using the new device. Thus, it is expected that an earlier closure of the abdominal wall will be possible, and a higher rate of primary closure will be attained.

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Title: A new device to prevent fascial retraction in the open abdomen – proof of concept in vivo
Authors: Roman Eickhoff
Maria Guschlbauer
Alexandra C. Maul
Christian D. Klink
Ulf P. Neumann
Michael Engel
Martin Hellmich
Anja Sterner-Kock
Christian F. Krieglstein
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Laparotomy
Laparotomy
Published in: BMC Surgery / Issue 1/2019
Electronic ISSN: 1471-2482
DOI: https://doi.org/10.1186/s12893-019-0543-3

At a glance: The STEP trials

Springer Medicine

A new device to prevent fascial retraction in the open abdomen – proof of concept in vivo

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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