Surgeons

Surgeons

Staged abdominal repair (STAR) has been proven to reduce mortality rate by up to 50% in patients with an APACHE score between 15 and 301. Used in conjunction with the artificial bur it has the highest delayed primary fascial closure rate of 90%2.

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§ 1 Theoretical Surg. 25(1994)25:273-284.
§ 2 Hensbroek, PB et al. World J Surg 33(2009)199-207

Families and Loved Ones

Families and Loved Ones

If you have a family member or loved one undergoing Staged Abdominal Repair (STAR) let us help you understand how this procedure and the Wittmann Hypopack™ help insure the best outcome.

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Hospital Administration

Hospital Administration

Hospitals that perform the STAR procedure can offer their high risk patients one more technique to decrease length of stay and avoidance of re-admissions, long term morbidity such as giant abdominal wall hernias and increased quality of life.

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Welcome to openabdomen.org

A resource for surgeons who treat the difficult abdomen. Our goal is to improve patient care by helping surgeons understand, utilize and explain staged abdominal repair in the treatment of the open abdomen.

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We accomplish this goal by providing:

  • State of the art information on the science of abdominal compartment syndrome
  • Detailed description of the staged abdominal repair (STAR) methodology
  • Discussions of the underlying diseases which cause the difficult to treat abdomen

Operative TechniqueOperative
Technique

Staged abdominal repair (STAR) is one operation consisting of multiple abdominal entries planned either before or during the first (index) STAR which are performed every 24-48 hours until final fascial closure is accomplished, including:

  • Closing the abdomen with a dynamic fascial expander prosthesis
  • Preventing fascial retraction
  • Controlling intra-abdominal pressure
  • Reversing pulmonary, renal, CV, hepatic and intestinal dysfunction/pathology
  • Delayed fascial closure after the last abdominal entry

Although a laparotomy or single abdominal entry is routine for any general surgeon, multiple sequential abdominal entries require more attention to detail with respect to timing, infrastructure & operative manipulations such resections & excisions as well as suturing leaks & anastomoses.

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Featured PublicationsFeatured
Publications

arrow  The Wittmann Patch as a temporary abdominal closure device after decompressive celiotomy for abdominal compartment syndrome following burn

Burns 2008

arrow  Closing the Open Abdomen: Improved Success With Wittmann Patch Staged Abdominal Closure

J Trauma 2008

arrow  The use of the Wittmann Patch facilitates a high rate of fascial closure in severely injured trauma patients and critically ill emergency surgery patients

J Trauma 2008

arrow  Delayed Primary Closure in Damage Control Laparotomy: The Value of the Wittmann Patch

Am Surg 2007

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Featured CasesFeatured
Cases

arrow  Diffuse peritonitis from anastomotic leaks.

Submitted By Dietmar Wittmann, MD, PhD, FACS

Year: 1992; Patient Age: 69

The patient is a 69 year old man with a history of morbid obesity (107kg, 172cm), hypertension and ischemic heart disease who had previously undergone two operations for diverticulitis.

arrow  Missed appendix perforation and severe abdominal compartment syndrome.

Submitted By Dietmar Wittmann, MD, PhD, FACS

Year: 1999; Patient Age: 13

This 13 year old boy had an appendectomy 9 days after onset of symptoms, because his condition was misdiagnosed as influenza. Ten days after resection of the perforated appendix, peritonitis persisted and abdominal re-explorations through a midline incision for multiple intra-abdominal abscesses became necessary.

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