Continuous retention suture for the management of open abdomen: a high rate of delayed fascial closure.

BACKGROUND AND AIMS: Open abdomen is most often a consequence of damage control surgery, abdominal decompression or intra-abdominal infections. Ventral hernia after unsuccessful closure of open abdomen causes marked disability to the patient. Several methods for delayed fascial closure have been developed. Patients treated with continuous retention suture were evaluated to find out how often fascial closure was achieved, and what complications were related to the technique.

METHOD: A retrospective analysis of 16 open abdomen patients treated with continuous retention suture.

RESULTS

The most common cause of open abdomen was abdominal infection. Complete fascial closure was achieved in nine of the eleven surviving patients. Closure failed in one patient. Partial closure was also achieved in one patient. The median time between leaving the abdomen open and starting the process of closure was twelve days. The longest period of open abdomen before successful fascial closure was 29 days. Five patients died before the process of closure was complete.

CONCLUSION

Delayed fascial closure can be accomplished by using the retention suture method described here.