{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T08:01:55Z","timestamp":1793865715154,"version":"4.6.1"},"reference-count":16,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,8,8]]},"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:p>We present the case of a 23-year-old man who developed abdominal compartment syndrome secondary to severe pancreatitis and required decompressive laparotomy and pancreatic necrosectomy. Despite application of a temporary abdominal closure system (ABThera Open Abdomen Negative Pressure Therapy), extensive retroperitoneal oedema and inflammation continued to contribute to loss of domain and prevented primary closure of the skin and fascia. The usual course of action would have involved reapplication of ABThera system until primary closure could be achieved or sufficient granulation tissue permitted split-thickness skin grafting. Though a safe option for abdominal closure, application of a skin graft would delay return to baseline functional status and require eventual graft excision with abdominal wall reconstruction for this active labourer. Thus, we achieved primary closure of the skin through the novel application of abdominal wall \u2018pie-crusting\u2019, or tension-releasing multiple skin incisions, technique.<\/jats:p>","DOI":"10.1136\/bcr-2021-244219","type":"journal-article","created":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T13:07:49Z","timestamp":1629205669000},"page":"e244219","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Application of pie-crusting technique to facilitate closure of open abdomen after decompressive laparotomy"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6194-2830","authenticated-orcid":false,"given":"Thomas J","family":"Martin","sequence":"first","affiliation":[{"name":"Department of Surgery, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6758-9150","authenticated-orcid":false,"given":"Tareq","family":"Kheirbek","sequence":"additional","affiliation":[{"name":"Department of Surgery, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,8,17]]},"reference":[{"key":"2025082709402606000_14.8.e244219.1","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.suc.2013.10.010","article-title":"Management of the open abdomen","volume":"94","author":"Demetriades","year":"2014","journal-title":"Surg Clin North Am"},{"key":"2025082709402606000_14.8.e244219.2","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s13017-018-0167-4","article-title":"The open abdomen in trauma and non-trauma patients: WSES guidelines","volume":"13","author":"Coccolini","year":"2018","journal-title":"World J Emerg Surg"},{"key":"2025082709402606000_14.8.e244219.3","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1001\/jamasurg.2013.2514","article-title":"Independent predictors of enteric fistula and abdominal sepsis after damage control laparotomy: results from the prospective AAST open abdomen registry","volume":"148","author":"Bradley","year":"2013","journal-title":"JAMA Surg"},{"key":"2025082709402606000_14.8.e244219.4","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s13017-015-0026-5","article-title":"The open abdomen, indications, management and definitive closure","volume":"10","author":"Coccolini","year":"2015","journal-title":"World J Emerg Surg"},{"key":"2025082709402606000_14.8.e244219.5","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1007\/s00268-014-2883-6","article-title":"Systematic review and meta-analysis of the open abdomen and temporary abdominal closure techniques in non-trauma patients","volume":"39","author":"Atema","year":"2015","journal-title":"World J Surg"},{"key":"2025082709402606000_14.8.e244219.6","doi-asserted-by":"crossref","first-page":"1656","DOI":"10.1177\/000313481107701238","article-title":"Management of fasciotomy wounds--does the dressing matter?","volume":"77","author":"Matt","year":"2011","journal-title":"Am Surg"},{"key":"2025082709402606000_14.8.e244219.7","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1097\/01.sla.0000086544.42647.84","article-title":"Staged management of giant abdominal wall defects: acute and long-term results","volume":"238","author":"Jernigan","year":"2003","journal-title":"Ann Surg"},{"key":"2025082709402606000_14.8.e244219.8","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1097\/TA.0000000000001615","article-title":"Treating pain on skin graft donor sites: review and clinical recommendations","volume":"83","author":"Sinha","year":"2017","journal-title":"J Trauma Acute Care Surg"},{"key":"2025082709402606000_14.8.e244219.9","first-page":"86","article-title":"Donor site morbidity following harvest of split-thickness skin grafts in South Eastern Nigeria","volume":"1","author":"Otene","year":"2011","journal-title":"J West Afr Coll Surg"},{"key":"2025082709402606000_14.8.e244219.10","doi-asserted-by":"crossref","DOI":"10.1016\/j.burns.2021.02.014","article-title":"Split-thickness skin graft donor-site morbidity: a systematic literature review","author":"Asuku","year":"2021","journal-title":"Burns"},{"key":"2025082709402606000_14.8.e244219.11","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-199306000-00012"},{"key":"2025082709402606000_14.8.e244219.12","doi-asserted-by":"publisher","DOI":"10.1007\/BF02015317"},{"key":"2025082709402606000_14.8.e244219.13","doi-asserted-by":"crossref","first-page":"851","DOI":"10.3113\/FAI.2007.0851","article-title":"Technique tip: use of \"pie crusting\" of the dorsal skin in severe foot injury","volume":"28","author":"Dunbar","year":"2007","journal-title":"Foot Ankle Int"},{"key":"2025082709402606000_14.8.e244219.14","doi-asserted-by":"publisher","DOI":"10.1177\/1938640015620635"},{"key":"2025082709402606000_14.8.e244219.15","unstructured":"@InvictaOrtho] Yelena Bogdan, MD FACS FAAOS. \"I get questions about \"pie-crusting\"\/ fenestration technique for fasciotomy wound closure, and how it heals. Here it is\" [Tweet]. Twitter, 2019. Available: https:\/\/twittercom\/invictaortho\/status\/1149356699955933187?s=21"},{"key":"2025082709402606000_14.8.e244219.16","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1016\/j.injury.2020.03.008","article-title":"Pressure reducing skin pie-crusting in extremity trauma: an in-vitro biomechanical study and human case series","volume":"51","author":"Capo","year":"2020","journal-title":"Injury"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-244219","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:40:33Z","timestamp":1756312833000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-244219"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8]]},"references-count":16,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2021,8,17]]},"published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10.1136\/bcr-2021-244219"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-244219","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8]]}}}