6 Powerful AbClo Statistics & Facts Based on Peer-Reviewed Clinical Evidence - Part 1

Part 1:

Applying AbClo Early Achieved a 98% Primary Fascial Closure Rate

Primary fascial closure rates are one of the most accurate indicators of success when discussing the use of open abdomens.

AbClo, through its unique mechanisms of action, provides reproducible, pressure-regulated, non-invasive, and effective fascial traction that grants one of the highest primary fascial closure rates available without relying on mesh-mediated closures or other invasive/surgical closure techniques. Let’s explore this more:

Closure rates in published literature are widely variable and often disputed. The overall primary fascial closure rate in open abdomen patients is currently 62%.1 However, closure rates across care settings are likely higher. In the 2022 EAST Guidelines on open abdomen care, the highest average primary fascial closure rate achieved, excluding AbClo, was 77.8% through the use of the Wittmann Patch traction system, an invasive approach.2

In the 2024 publication, “Early placement of a non-invasive, pressure-regulated, fascial reapproximation device improves reduction of the fascial gap in open abdomens: a retrospective cohort study”, Dr. Neils Martin et al. demonstrated AbClo’s highest potential primary fascial closure rate to be 98%.3 This closure rate was achieved non-invasively when AbClo was applied within 24 hours of the initial laparotomy, stressing the importance of early, preventative fascial traction in open abdomen care.

To ascertain that the patients studied were challenging enough to represent difficult primary fascial closure, the authors performed additional analyses;

In a setting omitting single-takeback closures, AbClo still offered a 94% primary fascial closure rate.
In the instance where AbClo was applied after the 24-hour period following the index laparotomy, the primary fascial closure rate was 85%. Still higher than that reported in the literature for other fascial traction systems.

AbClo’s ability to provide literature leading primary fascial closure rates in a reproducible manner without using invasive and damaging techniques shows again why non-invasive and preventative fascial traction should be leading the paradigm shift in managing patients with intentionally left open abdomens.

Comparison of primary fascial closure rates between Negative Pressure Wound Therapy (NPWT) alone, Wittmann Patch with NPWT, and AbClo with NPWT. AbClo gives the highest available device-mediated closure rate without relying on invasive techniques. — Comparison of primary fascial closure rates between Negative Pressure Wound Therapy (NPWT) alone, Wittmann Patch with NPWT, and AbClo with NPWT. AbClo gives the highest available device-mediated closure rate without relying on invasive techniques

Early Application of AbClo Reduces the Fascial Gap by 75% in 24 Hours

In the same 2024 study by Dr. Martin et al., AbClo’s ability to reapproximate the fascial gap in a time-sensitive manner was investigated.

As we continue to learn more about the physiological state of open abdomen patients, the clinical directive for care could not be clearer; prevention of fascial retraction results in smaller fascial gaps, earlier fascial closure, and fewer complications.

The reasoning: with each additional hour of open abdomen following 24 hours post-index laparotomy, primary fascial closure rate decreases by 1.1%.4 Additionally, as time to closure increases past 8 days, complication and mortality risk dramatically increase 5, largely due to infection, enteroatmospheric fistula formation and fascial retraction.6

Dr. Martin et al. found that when AbClo was applied within 24 hours of the initial laparotomy, the AbClo system regains 50% of the fascial gap within 8 hours and 75% of the fascial gap within 24 hours. AbClo helps to maintain the abdominal domain during the open abdomen, preventing fascial retraction and promoting early fascial closure even in the highest BMI patients.

AbClo functions by distributing the dynamic reapproximation tension across the entire abdominal wall without damaging the incisional edges. This force vector is transmitted through the skin, muscle, and fascia, preventing myofascial retraction and facilitating fascial movement back to the midline without any suturing.

Through the inclusion of a tension-monitoring system, the user of AbClo can confidently determine the tension applied to the abdominal wall, decreasing the risk of abdominal compartment syndrome during the use of the device. Think of AbClo as a fascial retraction prevention system!

CT-scan image of an open abdomen patient with AbClo applied. The arrows mark the skin and fascial edges, showing concomitant movement of the entire abdominal wall towards the midline.

Fascial Traction Systems, including AbClo, Conditionally Recommended by EAST Guidelines for Open Abdomen Care in Conjunction with NPWT

One of the biggest hurdles in modern open abdomen care is the lack of standardized, effective, and reproducible care options. These inconsistencies range from the type and amount of fluids used during resuscitation to optimal traction methods and closure approaches.

The Eastern Association for the Surgery of Trauma (EAST) is a leading body in North America for surgical research reviews and is one of the organizations pushing to uncover the best approaches for open abdomen care with the goal of publishing standard protocols in this field.

As mentioned earlier, EAST’s effort culminated in a 2022 publication titled, “Management of the open abdomen: A systematic review with meta-analysis and practice management guideline from the Eastern Association for the Surgery of Trauma”. In these guidelines, EAST performed a systematic review of studies related to optimal resuscitation methods (PICO 1) and fascial traction (PICO 2) as effective measures in increasing primary fascial closure while mitigating related complications.7

AbClo, being a fascial traction system, was investigated in PICO 2 and received a conditional recommendation for use in open abdomen care following laparotomy surgeries.

While the recommendation was conditional due to small sample sizes and difficulty identifying controls, fascial traction systems were found to, “improve the rate of primary myofascial closure over routine care without any worsening in mortality or ECF (enterocutaneous fistulas) formation.” 7

But why choose AbClo from the many alternatives listed? AbClo is the only studied and available fascial traction system that does not rely on invasive sutures into the abdominal wall and the only system that functions preventatively. The two main advantages of AbClo’s approach; a smaller fascial gap at the time of closure and undamaged fascia. Although other systems can offer an increase in primary fascial closure, the question can now be asked: at what cost? More surgical wounds? Longer hospital stays? More difficult care paths? Higher rates of future incisional hernias?

AbClo’s unique, non-invasive, and preventative approach avoids the undesirable consequences found with other techniques while maintaining a guideline-backed high quality of care.