Abstract
Background: In recent years, damage control surgery has been widely used, and as such, the number of patients with abdominal compartment syndrome has been increasing. Under this circumstance, it is often impossible to close the abdomen using standard methods. We often use the Wittman patch for these cases. Indication: Candidates for the Wittman patch are those who still have an open abdomen five days or more after temporary abdominal closure. We use vacuum pack closure for temporary abdominal closure. If the intra-abdominal pressure rises over 12 mm Hg after abdominal closure, use of the Wittmann patch is preferable to forcing abdominal closure. Every second day, the patch is closed as much as is tolerated in the ICU. The ability to sequentially approximate the abdominal wall prevents significant loss-of-domain and enables definitive abdominal closure. Results: We managed eight cases of open abdomen. It was possible to achieve definitive abdominal closure in a mean of 6.5 days (4^8 days). Definitive abdominal closure could be performed in all patients. None of the patients developed ventral hernia. Conclusion: It is possible to safely perform definitive abdominal closure using the Wittmann patch and measuring the intra-abdominal pressure.
