If the surgeon places the patch without abdominal exploration, you should look instead to an appropriate integumentary system closure code (for instance, 13160, Secondary closure of surgical wound or dehiscence, extensive or complicated), with modifier -58 appended.

Abstract domen ” has likely contributed to im-proved outcomes in trauma patients, the challenge of subsequent fascial closure has emerged. Since mid 2004, we have incor-porated Wittmann Patch staged abdomi-nal closure into our management of the open abdomen. The purpose of this study was to evaluate the impact of this device on our incidence of fascial closure versus planned ventral hernia. Methods: Patients managed by open abdomen from 2001 through 2006 were identified from the trauma registry.

Ugolovnij kodeks turcii na russkom 10. Fas-cial closure immediately after definitive repair of injuries was defined as “early fascial closure. ” Continuation of the open abdomen beyond the definitive repair of injuries with subsequent fascial closure was defined as “delayed fascial closure.” Since April 2004, the Wittmann Patch was uniformly employed in open abdo-men management.

Patients managed be-fore the use of this device (“pre-Patch”) were compared with those managed in the “Patch ” era. Results: Fifty-six open abdomens were managed in the pre-Patch era and 103 were managed in the Patch era.

In the pre-Patch era, 33 (59%) underwent early fascial closure, compared with 67 (65%) in the Patch era (p NS). For the remaining patients, the incidence of delayed fascial closure was significantly higher in those managed with the Wittmann Patch com-pared with those managed in the pre-Patch era (78% vs.

Abstract Open abdomen (OA) has been an effective treatment for abdominal catastrophes in traumatic and general surgery. However, management of patients with OA remains a formidable task for surgeons. The central goal of OA is closure of fascial defect as early as is clinically feasible without precipitating abdominal compartment syndrome.

Historically, techniques such as packing, mesh, and vacuum-assisted closure have been developed to assist temporary abdominal closure, and techniques such as components separation, mesh-mediated traction, bridging fascial defect with permanent synthetic mesh, or biologic mesh have also been attempted to achieve early primary fascial closure, either alone or in combined use. The objective of this review is to present the challenges of these techniques for OA with a goal of early primary fascial closure, when the patient’s physiological condition allows.