Welcome back to AbClo’s blog on everything open abdominal. In this post we will dive into AbClo, its beginnings, how it functions, and the outcomes you can expect with usage.

AbClo’s beginnings trace back to Federal University of Minas Gerais where the young co-inventor Dr. Joao Rezende-Neto was tasked with managing an overflow of left open abdomen patients. A lack of innovation in abdominal surgical healing meant that most of these patients failed to close and had significant clinical burdens moving forward in life. This thought stayed with Dr. Rezende-Neto until he met Dr. Ori Rotstein at St. Micheal’s in Toronto. Together, Dr. Rezende-Neto and Dr. Rotstein developed AbClo as the newest innovation in open abdominal management since negative pressure wound therapy and AbThera.

How AbClo Works & How To Use It

AbClo functions as a management device for the open abdomen, preventing abdominal wall lateralization and holding the incisional edges of the wound defect close to the midline until the surgeon is ready to close. Mechanistically, it applies circumferential and directed pressure to the entire abdominal wall and the lateral edge of the rectus abdominus muscle.

Application of AbClo involves wrapping a circumferential dynamic retainer (CDR), or binder, around the patient’s torso and clipping the taught binder into two rectus muscle splints on both sides of the incision. The splints are then pushed down and inward towards the midline, engaging the entire abdominal wall. Tensioners are then pulled across the incision and clipped into both splints, stabilizing the applied pressure of the splints and dynamically engaging the rectus abdominus muscle. Over time, this pressure slowly pushes on the abdominal wall until the incisional edges are brought together.

As a step forward in post-surgical wound care, AbClo also incorporates a quantitative monitoring system via a balloon and gauge system. A pressure-sensitive balloon is placed under the tensioners which are tightened to a pressure indicated by the green zone on the adjacent gauge. While in the green zone, patients receive enough tractional force to medialize and reapproximate the muscles and fascia while not increasing inter-abdominal pressure, as to not risk abdominal compartment syndrome.

Clinical Testing & Results

Once Dr. Rotstein and Dr. Rezende-Neto had finalized the design of AbClo, it was time to test this abdominal closure technology in a clinical setting. With all needed approvals, the first prospective clinical study on the management of the open abdomen using AbClo began in 2019. The results were unprecedented.

The main findings of the trial positioned closure rates of the current standard of care with only negative pressure wound therapy (AbThera) against closure rates with AbClo and negative pressure wound therapy. The results, AbClo increased closure rates by 53%, moving from 55.6% success to 85% success. AbClo was also shown to significantly decrease the size of the abdominal defect over time, something just AbThera could not do. But what do these findings really imply?

Since open abdomen approaches began being developed, there has been a fear of failure leading to costly and physiologically challenging planned ventral hernias. AbClo allows surgeons and patients to choose their care paths comfortably, knowing that even if the open approach is taken, the risk of complications doesn’t have to be a burden on your shoulders… or should I say abdomen!

In our next post where we will take you to a first unique case study using AbClo. Click here to read on.

Interested in learning more about the AbClo? Click here.