Modification of Negative Pressure Wound Therapy and Mesh-Mediated Fascial Traction for Open Abdomen Treatment.

Abstract

The introduction of the open abdomen technique for laparostomies has presented new problems, including the method of temporary coverage and the primary and delayed closure of the laparostomy. Numerous techniques for the delayed closure of a laparostomy have been described in the literature, but closure of a laparostomy with a colostomy present is a more technically challenging situation. The combination of negative pressure wound therapy and mesh-mediated fascial traction is now considered the method of choice. This paper presents a modification of the negative pressure wound therapy and mesh-mediated fascial traction techniques, by which laparostomy closure can be easily and quickly achieved by applying mesh as a whole and applying traction on the excess part. The traction on different parts of the mesh can be easily adjusted to avoid colostomy compression.