Novel Abdominal Dressing Increases Medial Tissue Movement over Standard of Care and Competitor

Introduction: Temporary abdominal closure using a visceral protective layer and controlled negative pressure delivered through a reticulated open cell foam has become the standard of care since its introduction in 2009. A key aspect of utilizing this system is the medial tension, purported to assist in minimizing fascial retraction and loss of domain, applied along the wound edges. The study objective was to evaluate and compare the ability of the standard of care dressing to deliver medial tissue movement in a benchtop model with two other dressings that have recently become available.

Methods: Dressings (n=6) were installed in each of four configurations per instructions for use in a model designed to simulate an open abdomen following laparotomy. Datum marks were transferred onto each dressing using a template and the dressings connected to a therapy unit with leak rate confirmed to be <0.200 LPM; Distances between datum marks were re-measured with negative pressure applied.

Results: In all configurations, the mean percentage medial closure (MPMC) for TAC 2 was greater than the other tested dressings. The MPLC effect was most profound when two layers were used in the test system, one tucked under the edges of the created defect (simulating contact with the fascia) and a second layer placed superficially within the edges of the defect. MPMCs were 17.9%, 21.1%, and 14.1% for TAC 1, 2, and 3, respectively. MPMCs ranged from 6.1% to 9.8% when a single foam layer was placed within the defect. TAC 3 consistently had the lowest MPMC in all test configurations.

Conclusions: Of the two new TAC systems available, one offers significantly improved abdominal closure over the stand of care and one significantly less.