The Wittmann Patch™ as 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 (TM) was 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 (TM) closure. Survivors subsequently under-went primary abdominal closure, with no evidence of ventral hernia at long-term follow-up. Conclusion: In burn cases with abdominal compartment syndrome, a Wittmann Patch (TM) may prove a helpful method of temporary abdominal closure, followed by primary closure with no complications. (c) 2007 Elsevier Ltd and ISBI. All rights reserved.