Trans-abdominal wall traction as a universal solution to the management of XXXX .

@entity1 @entity4037 @entity102
BACKGROUND: Domain loss following damage-control laparotomy is a challenging problem many surgeons face. The authors recently developed trans-abdominal wall traction, which closed 100 percent of domain loss abdomens in the acute setting. They hypothesized that it can be used successfully in @entity1 with @entity102 . METHODS: From 2008 to 2013, 44 @entity1 with acute loss of domain and 10 with chronically @entity4037 were enrolled in the open abdomen protocol with subsequent placement of the trans-abdominal wall traction device. RESULTS: @entity1 ' average age in the acute and chronic groups was 28.2 and 35.3 years and average body mass index was 26.4 and 32.4 kg/m2, respectively. @entity4037 size was reduced with the first trans-abdominal wall traction insertion from 610.5 cm2 to 274.6 cm2 in the acute setting and from 598 cm2 to 236.9 cm2 in the chronic setting. Average time from damage-control laparotomy to device insertion was 12.9 days in the acute group and more than 3 years in the chronic group. Lost domain was achieved with an average of less than 2.5 trans-abdominal wall traction tightenings, correlating to 9.2 and 8.2 days in the acute and chronic groups, respectively. Enterocutaneous fistula occurrence was 9 percent in the acute group and 0 percent in the chronic group. CONCLUSIONS: All @entity1 were successfully closed after reestablishment of the lost domain. Trans-abdominal wall traction is an effective means of reestablishing abdominal domain and achieving primary abdominal wall closure in all @entity1 with @entity4037 , both acute and chronic.
