PDF(Pubmed)
Abstract：
The Abdominal Re-Approximation Anchor (ABRA®) is a pivotal dynamic wound closure system utilized for achieving primary fascial closure in patients undergoing open abdomen surgeries. However, its efficacy can be hindered in patients with class III obesity due to anatomical complexities and compromised tissue characteristics. Here, we present the unique case of a 25-year-old woman with class III obesity (body mass index (BMI) ≥ 40 kg/m2) who required primary abdominal closure following complications of an ileostomy repair. Traditional placement of the ABRA device was not feasible due to thick subcutaneous tissue layers. Consequently, a modified application of ABRA was decided based on clinical judgment, whereby the ABRA button anchors were strategically placed internally under the subcutaneous tissue instead of externally on the skin surface. The patient completed six intraoperative tightenings of the ABRA device via this novel technique and was treated with washouts over the course of two months until complete resolution was achieved. The presented case demonstrates a successful modification of the ABRA wound closure device to suit an open abdomen patient with class III obesity.
摘要：
腹部再逼近锚（ABRA®）是一种关键的动态伤口闭合系统，用于在进行开放式腹部手术的患者中实现初次筋膜闭合。然而,在III类肥胖患者中,由于解剖学复杂性和受损的组织特征,其疗效可能受到阻碍.这里,我们介绍了1例3级肥胖(体重指数(BMI)≥40kg/m2)的25岁女性患者在回肠造口术修复并发症后需要进行原发性腹部闭合的独特病例.由于厚的皮下组织层,ABRA装置的传统放置是不可行的。因此,根据临床判断决定ABRA的改良应用，由此将ABRA按钮锚策略性地放置在皮下组织的内部而不是皮肤表面的外部。患者通过这种新技术完成了ABRA装置的六次术中收紧，并在两个月的时间内进行了冲洗治疗，直到达到完全解决。所呈现的病例证明了ABRA伤口闭合装置的成功修改，以适合患有III类肥胖的开放腹部患者。
