Use of Fascial Traction Device in Open Abdomen Closure – A Case Report

Abstract Aim Open abdomen management is a therapeutic option for patients in whom abdominal wall closure should not or cannot be performed. Deferred closure of the abdominal wall often presents difficulties and comorbidity. The use of a fascial traction device may yield benefits in these patients. Material and Methods Description of a clinical case. Results A 68-year-old male with diabetes mellitus, hypertension, history of smoking, and former alcohol use underwent orthotopic liver transplantation for alcoholic cirrhosis, hepatitis C virus, and hepatocellular carcinoma. Complications included hemorrhagic shock requiring re-intervention. Damage control surgery was performed leaving the abdomen open, and a fascial traction device was applied. The device was maintained for 5 hours, followed by a 1-hour rest period, repeated for 4 days. Following this period, with patient stabilization, abdominal wall closure was performed, demonstrating significant fascial approximation and achieving primary closure using the small bites technique in two layers. The only complication encountered was a seroma. The patient was discharged 27 days post-intervention. Conclusions In patients with an open abdomen, deferred closure of the abdominal wall is often complex due to fascial retraction. Therefore, the use of fascial traction devices in these cases may offer a significant advantage for abdominal wall closure, potentially avoiding or reducing fascial retraction and, in many cases, obviating the need for complex wall repair techniques in these fragile patients.