Abdominal re-approximation anchor system (ABRA)

Abdominal re-approximation anchor system (ABRA) can be used to perform a temporary abdominal closure (TAC) or open abdomen (OA) as part of damage control surgical (DCS) interventions in trauma, peritonitis or pancreatitis and generally in all those conditions at risk of intra-abdominal pressure (IAP) increase.

It is used to prevent or to treat the intra-abdominal hypertension (IAH) or the abdominal compartment syndrome (ACS). The peculiarity of this technique is that it is also used to re-approximate fascial edges in “long-course” open abdomen. It progressively re-approximates the edges with at continuous traction system composed by dynamic retention elastomers passed trough the abdominal wall and anchored through anchorage buttons outside the abdomen. This technique could preserve the abdominal wall domain is used early.

Its major disadvantages are the impossibility to assess the intra-abdominal content without re-open the abdomen and the impossibility of an effective removal of infected or toxin- and cytokine-rich intra-peritoneal fluid and the high risk of intra-abdominal pressure increase. This technique can be combined with the negative pressure.