{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T03:20:44Z","timestamp":1776914444261,"version":"3.51.2"},"reference-count":23,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2011,8,18]],"date-time":"2011-08-18T00:00:00Z","timestamp":1313625600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/2.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2011,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The major challenge in the management of patients with an infected open abdomen (OA) is to control septic peritonitis and intra\u2010abdominal fluid secretion, and to facilitate repeated abdominal exploration, while preserving the fascia for delayed primary closure. We here present a novel method for closure of the infected OA, based on continuous dynamic tension, in order to achieve re\u2010approximation of the fascial edges of the abdominal wall.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eighteen cases with severe peritonitis of various origin (e.g., gastrointestinal perforations, anastomotic leakage) were primarily stabilized by laparostomy, sealed with either the vacuum\u2010assisted closure abdominal dressing or the Bogot\u00e1 bag. After hemodynamic stabilization and control of the sepsis, the Abdominal Re\u2010approximation Anchor System (ABRA; Canica Design, Almonte, Ontario, Canada) was applied. This system approximates the wound margins through dynamic traction exerted by transfascial elastomers. Before ABRA application, 5\/18 patients had a grade 2B, 2\/18 a grade 3, and 11\/18 a grade or 4 status according to the open abdomen classification of Bj\u00f6rck.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this severely ill population the mean time before ABRA system application was 12\u00a0days (range: 2\u201339\u00a0days). Two of 18 patients died of non\u2010ABRA\u2010related causes within three weeks. In 14 of the remaining 16 patients (88%) primary abdominal closure of the midline was accomplished in 15\u00a0days (range: 7\u201330\u00a0days). The other two patients needed a component separation technique according to Ramirez to reach closure. However, secondary wound dehiscence occurred in both these patients. Two thirds of patients (12\/18) developed pressure sores to the skin and\/or dermis, but all healed without further complications. During outpatient clinic follow\u2010up, 4\/14 successfully closed patients still developed a midline hernia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Delayed primary closure of OA in septic patients could be achieved in 88% with this new approximation system. However, the risk of hernia development remained. We consider this system a useful tool in the treatment of septic patients with an open abdomen.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-011-1210-8","type":"journal-article","created":{"date-parts":[[2011,8,17]],"date-time":"2011-08-17T18:01:04Z","timestamp":1313604064000},"page":"2348-2355","source":"Crossref","is-referenced-by-count":66,"title":["Delayed Primary Closure of the Septic Open Abdomen with a Dynamic Closure System"],"prefix":"10.1002","volume":"35","author":[{"given":"Froukje J.","family":"Verdam","sequence":"first","affiliation":[{"name":"Department of General Surgery Amphia Hospital P.O. Box 90158 4800 RK Breda The Netherlands"},{"name":"Department of General Surgery Maastricht University Medical Centre Maastricht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis E. J. G. J.","family":"Dolmans","sequence":"additional","affiliation":[{"name":"Department of General Surgery Amphia Hospital P.O. Box 90158 4800 RK Breda The Netherlands"},{"name":"Department of General Surgery Atrium Medical Center Heerlen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maarten J.","family":"Loos","sequence":"additional","affiliation":[{"name":"Department of General Surgery M\u00e0xima Medical Centre Veldhoven The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Menno H.","family":"Raber","sequence":"additional","affiliation":[{"name":"Department of General Surgery Medical Spectrum Twente Enschede The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralph J.","family":"de Wit","sequence":"additional","affiliation":[{"name":"Department of General Surgery Medical Spectrum Twente Enschede The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan A.","family":"Charbon","sequence":"additional","affiliation":[{"name":"Department of General Surgery M\u00e0xima Medical Centre Veldhoven The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos P. A. M.","family":"Vroemen","sequence":"additional","affiliation":[{"name":"Department of General Surgery Amphia Hospital P.O. Box 90158 4800 RK Breda The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2011,8,18]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3181da0da5"},{"issue":"2","key":"e_1_2_6_3_2","first-page":"1","article-title":"Managing the open abdomen","volume":"50","author":"Kaplan M","year":"2004","journal-title":"Ostomy Wound Manage"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.TA.0000070166.29649.F3"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/145749690709600408"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2007.05.015"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.TA.0000101067.52018.42"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010008\u20109867\u20103"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/000313480407000718"},{"key":"e_1_2_6_10_2","first-page":"209","article-title":"Management of open abdominal wounds with a dynamic fascial closure system","volume":"51","author":"Reimer MW","year":"2008","journal-title":"Can J Surg"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sap.0000237052.11796.63"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800841110"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010009\u20109996\u20103"},{"key":"e_1_2_6_14_2","first-page":"18","article-title":"Fourth national pressure ulcer prevalence survey","volume":"10","author":"Barczak CA","year":"1997","journal-title":"Adv Wound Care"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534\u2010199009000\u201000023"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2010.042"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010008\u20109762\u2010y"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2006.06.001"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2006.04.010"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.7383"},{"key":"e_1_2_6_21_2","first-page":"S1","article-title":"Management of the open abdomen: from initial operation to definitive closure","volume":"75","author":"Campbell A","year":"2009","journal-title":"Am Surg:"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsurg.2008.12.003"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.137.11.1298"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2004.03.007"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-011-1210-8","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T16:29:53Z","timestamp":1703608193000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-011-1210-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,8,18]]},"references-count":23,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2011,10]]}},"alternative-id":["10.1007\/s00268-011-1210-8"],"URL":"https:\/\/doi.org\/10.1007\/s00268-011-1210-8","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,8,18]]}}}