Wittmann Patch
The Wittmann Patch is a Velcro®-like device for bridging and re-approximating abdominal wall openings where primary closure is not possible and/or repeat abdominal entries are necessary.
The Wittmann Patch is often used with open abdomen negative pressure treatment when negative pressure treatment alone isn't enough to achieve fascia-to-fascia closure. Use of the Wittmann Patch, ideally before lateral retraction and loss of abdominal domain, can help achieve abdominal wall closure and avoid a planned ventral hernia.
The Wittmann Patch consists of hook-and-loop (Velcro®-like) sheets that are pressed together to form a secure closure and peeled apart for abdominal re-entry. The overlap is adjusted to accommodate an increase or decrease in swelling. Applying a slight tension helps prevent lateral retraction. As abdominal swelling decreases, the fascial edges are pulled closer together and excess patch material is trimmed. When the two fascial edges are close enough, the remaining patch material is removed and the abdominal wall is closed by suturing fascia-to-fascia.
The Wittmann Patch has been used to treat conditions associated with an extended course of open abdomen management including:
- intra-abdominal infections
- abdominal trauma
- bowel ischemia
- acute pancreatitis with and without infection
- ruptured abdominal aortic aneurysms
- abdominal organ transplantation
- multiple adhesions, enteric fistulas, and failed hernia repairs with meshes
- reconstruction of large abdominal hernias without components separation or prosthetic material
Wittmann Patch TAWT Surgical Technique Video
Wittmann Patch TAWT™ Cross Section
“TAWT consistently recaptures lost domain, preserves the leading fascial edge, and eliminates the need for biologic bridges, components separation, or skin grafting.”
Dennis AJ et al: Not so fast to skin graft: Transabdominal wall traction closes most ‘‘domain loss’’ abdomens in the acute setting. J Trauma Acute Care Surgery, 2013: 74, (6) 1486-1492.
“Regardless of the cause of the giant ventral defect or the length of time it has existed, trans-abdominal wall traction can recapture abdominal domain and achieve midline fascial approximation and closure.”
Dennis AJ et al: Trans-Abdominal Wall Traction as a Universal Solution to the Management of Giant Ventral Hernias. Plastic and Reconstructive Surgery, 2015; 135: 4, 1113–1123.
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