The Wittmann Patch™ as a temporary abdominal closure device after decompressive celiotomy for abdominal compartment syndrome following burn

BackgroundAbdominal compartment syndrome is frequently the result of aggressive fluid resuscitation after burn. Management of the open abdomen following decompressive celiotomy is a major problem.MethodsFrom 2004 to mid-2005, six patients required decompressive celiotomy after developing abdominal compartment syndrome as a result of burn. A Wittmann Patch™ 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.ResultsOf 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™ closure. Survivors subsequently underwent primary abdominal closure, with no evidence of ventral hernia at long-term follow-up.ConclusionIn burn cases with abdominal compartment syndrome, a Wittmann Patch™ may prove a helpful method of temporary abdominal closure, followed by primary closure with no complications.