(Recap of blog post 2)
The AbClo device represents an outstanding advancement that aims to revolutionize the non-invasive management of open abdomen cases. AbClo helps achieve definitive primary closure through dynamic therapeutic tension, which gradually reduces the fascial defect and returns the wound edges to the midline.
AbClo is indicated for use in all acute or trauma-based open abdomen (laparotomy) adult patients, except conditions that could prevent the device from being positioned on the abdominal wall or could be exacerbated by its application, such as abdominal wall necrosis or major burns.
AbClo offers a safer and more efficient approach that simplifies complex surgical scenarios, such as acute care surgery, high BMI patients, or elderly patients.
Key Clinical Features of the AbClo Device
Fewer incisions and scars—being non-invasive, AbClo also helps reduce additional surgical site incisions in the skin and fascia that are commonly found with other, invasive, traction devices.
Better outcomes—with a 98% primary fascial closure rate, AbClo outperforms current standards of OA care and surpasses those of competitor devices.
Reduced risk of complications—faster, more effective closure reduces the risk of complications like entero-cutaneous fistulas or ventral hernias, conditions that lead to longer recovery and higher recurrence rates.
The earlier the better—elevated outcomes are obtained with AbClo early application.
Continuous access to the abdominal cavity—this feature enables monitoring signs of infection or other complications while still providing the necessary degree of closure that promotes healing.
The AbClo device can be removed and replaced—this allows for full abdominal access in cases where a second look or follow-up abdominal surgeries are required.
Compatible with CT imaging—CT scans are particularly useful when used with AbClo, not only in identifying any complications related to the abdominal wall closure or the function of the AbClo device, but also in monitoring fascial closure progress, especially in patients with high BMI.
Improved patient experience—AbClo reduces ICU length of stay by up to 50% and cuts down surgical takebacks by 25%, meaning less time under anesthesia and less exposure to post-surgical risks.
(Blog 3 of 3)
“WHAT’s Beyond” the AbClo
AbClo Clinical Implications
As clinical evidence and physicians alike continue to show elevated outcomes with early and aggressive closure timelines, AbClo has presented itself as an effective supporting technique to accelerate these closure goals further.
AbClo vs Competitor Devices
A retrospective study aimed to compare the primary fascial closure rate using the AbClo device versus the Wittmann patch in trauma and emergency general surgery patients who underwent damage control laparotomy at two level 1 trauma centers in Canada and USA between 2017 and 2022. Successful fascial closure took longer in the Wittmann patch (6.4 days ± 5.1 days) compared to the AbCLo group (3.7 days ± 2.1 days). Nevertheless, the total number of trips to the operating room was significantly higher in Wittmann patch patients compared to the AbCLo group (mean, 2.4 ±1.7 vs. 1.8 ±1). 1
More importantly, all AbClo devices were applied at the bedside without any surgical procedure; however, the Wittmann Patch must be surgically sutured to the abdominal fascia in the OR.
AbClo Early Application.. An Evident Advantage
A retrospective cohort study (published in The Journal of Trauma and Acute Care Open) reveals the critical role of early intervention in achieving optimal outcomes for patients while reducing overall costs. The study included all patients who had the abdominal fascia intentionally left open after a damage control operation for trauma and emergency general surgery, and were managed with the AbClo device between January 1st, 2020, and December 31st, 2023, in an academic hospital. The time of device placement in relation to the end of index laparotomy was defined as early (≤24 hours) versus late (>24 hours).
The study found that primary myofascial closure rate with early (≤24 hours) application of the AbClo device was 98% versus 85% with late application, and that fascial approximation was 22% higher for the early placement group.
AbClo Key Clinical Studies Findings Takeaways
- AbClo reduces with fascial gap by 74.5% within 24 hours of placement when applied early (<24 hours).
- Achieved a 98% primary closure in this peer-reviewed clinical trial vs. 55.6% in the referenced literature.
- Early application (<24 hours) with AbClo achieves faster closure (3.7 vs. 6.4 days) and fewer OR trips (1.8 vs. 2.4 takebacks). 2
- No cases of fascial dehiscence or additional skin injury complications related to the device were seen when AbClo was used with NPWT.
- AbClo is the only non-invasive traction device available and has been recommended for open abdomen closure by multiple published studies.
AbClo & Healthcare Expenditure .. Numbers That Matter
The economic burden associated with OA management is associated with prolonged lengths of hospital stay, and the use of current in-hospital management strategies to achieve eventual primary closure, which have variable and often suboptimal efficacy. The risks of infection, prolonged time on a ventilator, loss of domain, increased attendant time, increased OR time, and even mortality resulting from these additional visits add a costly burden to the healthcare system.
Reduced Hospital Strain
The use of AbClo has proven to be an economically attractive strategy for the management of OA.
An overwhelming superiority of AbClo is the fact that it can be applied and managed by healthcare professionals at the bedside: no need to take the patient to the OR. This advantage leads to a 50% reduction in ICU days, 25% fewer OR takebacks¹, and a corresponding reduction in consumables and physician hours, which dramatically cuts down critical care costs and saves thousands of dollars.
AbClo’s Real Economic Value
A peer-reviewed health economic study3 assessed the economic implications of AbClo with NPWT compared to NPWT alone on OA management. In that study, a cost-minimization analysis was conducted using a decision tree comparing the use of the AbClo device with NPWT to NPWT alone among patients with midline laparotomy for trauma or acute abdominal surgery who were ineligible for primary fascial closure. The time horizon was limited to the length of the inpatient hospital stay, and costs were considered from the perspective of the US Medicare payer.
The study results showed that the mean cumulative costs per patient were $76,582 for those treated with NPWT alone and $70,582 for those in the group treated with the AbClo device. Consequently, compared to NPWT alone, AbClo was associated with lower incremental costs of −$6012, while the probability that AbClo was cost-saving compared to NPWT alone was 94%. The same published health economic analysis showed cost savings of up to $19,449 per patient.
It should be noted for conversation that this economic study had 2 major limitations. Firstly, the application of AbClo was limited to beyond 48 hours following the initial laparotomy, leading to lower primary fascial closure rates. Secondly, the time horizon was limited to the length of the inpatient hospital stay. Given that failed abdominal closures can cost up to $150,000 more per patient, AbClos cost savings for the lifetime of the patient’s care is likely much higher as AbClo is now shown to prevent those failures in 98% of cases.
Institutions like St. Michael’s Hospital have anecdotally reported savings of up to $40,000 per patient when using AbClo on every OA patient. That translates into an estimated $1.6 million in savings per hospital site.
Key Takeaways
- Up to $19,449 savings per patient in 94% of cases using AbClo & NPWT versus NPWT alone.
- Up to $1.6 million in average savings per trauma centre.
- 50% shorter ICU stays.
- 25% fewer OR takebacks, less surgical strain, and shorter time in the OR
- Reusability on the same patient further reduces material waste and cost per procedure.
On top, when considering that planned ventral hernia repairs cost the healthcare system nearly $10 billion annually, AbClo’s role in preventing those hernias becomes even more compelling.
AbClo’s “On the Rise” Clinical Adoption
Across clinical sites globally, the adoption of AbClo has grown exponentially. AbClo usage is already established in 35+ hospitals and trauma centers.
Every site that has evaluated AbClo has chosen to fully integrate it into their practice, which is a validation of its reliability and impact on patient care.
AbClo’s Empowering “Hands-On”
AbClo has trained over 800 healthcare professionals in the device’s proper use and integration into clinical workflows. In addition to on-site training, AbClo users get access to virtual training modules, courses, and videos providing extensive information on everything AbClo.
Future Directions of AbClo .. What’s Next?
AbClo is set to shift the paradigm of the future abdominal closure technology with ongoing research, expanded clinical partnerships, and development efforts, all powered by a continued focus on enhancing effectiveness, adaptability, and ease of use in various clinical contexts.
Future research on the AbCLO device will focus on long-term outcomes and effects, specifically assessing its impact on respiratory mechanics and lung function in patients with an open abdomen.
Key Areas for Future Research and Advancements:
- Long-Term Outcomes
Studies will continue to examine the long-term effectiveness of early AbClo placement in achieving primary myofascial closure and preventing adverse long-term effects like lateralization and contraction of the abdominal wall.
- Clinical Efficacy and Comparison
While early results show high success rates for primary closure, new research will compare the effectiveness of the AbClo device over time and against other abdominal closure methods.
- Health Economics and Resource Utilization
Further economic analyses are planned to establish the cost-effectiveness of AbClo compared to standard care, particularly given its non-invasive nature and point-of-care application.
- Interprofessional Collaboration
The establishment of an AbClo superuser group and continued expansion of clinical training initiatives will foster increased interprofessional thought exchange and help standardize and improve OA care.
Finally.. Don’t Fear the Open Abdomen!
AbClo’s innovative features and its concomitant use with NPWT devices, such as AbThera, position it as a fundamental tool in the surgical toolkit, assisting clinicians in delivering optimal patient outcomes while mitigating the risks associated with open abdomen management.
Studies show promising results, indicating that the use of the AbClo device not only improves closure rates but also shortens hospital stays and enhances overall patient satisfaction.
As these techniques become more standardized, so will the reduction of fear related to open abdomen procedures. 4
If you are Interested in learning more about AbClo, integrating the AbClo system into your practice, or participating in a demo, click here.
REFERENCES
- Wael Abosena MD, Mohammed Bawazeer MD, Marc Antoine Fortin MD, Joao Rezende-Neto MD, et. al. Comparison of Primary Fascial Closure Rate in Open Abdomen Management: Wittmann Patch versus Abdominal Fascia Closure Devicehttps://abclomedical.com/wp-content/uploads/2024/07/9.-Comparison-of-Primary-Fascial-Closure-Rate-in-Open-Abdomen-Management_-Wittmann-Patch-versus-Abdominal-Fascia-Closure-Device.-Wael-Abosena-Et-al.pdf
- Fascial Closure Achieved Faster With AbClo (3.7 Days vs 6.4 Days) (2025). https://abclomedical.com/6-powerful-abclo-statistics-facts-based-on-clinical-evidence-part-2/#:~:text=In%202024%2C%20Tufts%20University%20researchers,Germany%20by%20Willms%20et%20al.
- Chew DS, Dayal T. Economic Analysis of AbClo, a Novel Abdominal Fascia Closure Device, for Patients With an Open Abdomen Following Trauma or Acute Abdominal Surgery. Surg Innov. (2024). https://pmc.ncbi.nlm.nih.gov/articles/PMC11047009/#:~:text=The%20mean%20cumulative%20costs%20per,ineligible%20for%20primary%20fascial%20closure.
Hector Mejia Morales, David A Hampton. Do not fear the open abdomen (2024). https://tsaco.bmj.com/content/9/1/e001647