Temporary Abdominal Closure Techniques

Critically ill patients with underlying intraabdominal hypertension due to sepsis or injury are often managed with a damage control laparotomy (DCL), which involves the minimum intervention necessary to save the patient’s life. In order to save time, the abdomen may be left open to facilitate a second look to confirm the control of bleeding or sepsis before fascial closure. In the interim, some patients will develop bowel and abdominal wall edema with a high-volume resuscitation, especially if the crystalloid fluid is used primarily.

The many causes and management of intraabdominal hypertension as well as the indications for a damage control laparotomy are discussed in other topics. Here we focus on the temporary techniques that are used to hold the abdomen together, ways to facilitate eventual fascial closure, and the complications of these techniques. Other topics will describe the eventual reconstruction of the abdominal wall when the fascia cannot be closed.