Tawt technique for abdominal repair using the wittmann patch. Several methods have been described to promote closure during the initial admission, including the wittmann patch star surgical and the vac devices. Mar 03, 2005 the remaining 17 were managed using an algorithm including a combination of delayed primary closure dpc, vacuumassisted fascial closure vafc, wittmann patch wp star surgical, inc. The remaining 17 were managed using an algorithm including a combination of delayed primary closure dpc, vacuumassisted fascial closure vafc, wittmann patch wp star surgical, inc. The authors hypothesized that use of the wittmann patch would lead to a high rate of delayed primary closure of the abdomen. Outcomes and complications of open abdomen technique for. No surgeon starts an elective operation planning to leave the or with the. The wittmann patch is often used with open abdomen negative pressure treatment when negative pressure treatment alone isnt enough to achieve fasciato. They decided to market the patch as the wittmann patch. The approach to staged repair using the wittmann patch star surgical inc. University of hamburg, germany, university of dusseldorf, germany, university of california san francisco medical school,usa, hahnemann medical school, philadelphia,usa, medical college of wisconsin milwaukee, usa. Part 1 is divided into indications for the open abdomen, temporary abdominal closure, staged abdominal.
The wittmann patch is a velcro like device for bridging and reapproximating abdominal wall openings where primary closure is not possible andor repeat abdominal entries are necessary. The wittmann patch is a velcro like device for bridging and reapproximating abdominal wall openings where primary closure is not possible andor repeat abdominal entries are necessary the wittmann patch is often used with open abdomen negative pressure treatment when negative pressure treatment alone isnt enough to achieve fasciatofascia closure. Delayed closure of ventral abdominal hernias after severe trauma. Delayed closure of ventral abdominal hernias after severe. Star cites wittmann s feeling of betrayal by deutsch, his removal of star s content from the. Wittmann and his colleagues at the medical college of. The wittmann patch s a temporary abdominal closure device. This giant ventral hernia may then be dealt with using various reconstructive techniques after a long.
During the period from june 2002 to may of 2006, 29 patients were identified. Due to sepsis and ongoing fluid requirements, the patient required an open abdomen for an extended period of time. Vac devices have been reported to have success rates ranging from 71% to 92% in achieving primary closure during the initial admission in surviving trauma patients 18, 19. We pride ourselves in the quality and value of the service we provide. The fascia prosthesis became commercially available in europe in 1992 hidih. Patients were reexplored when clinical parameters improved and the abdomen was closed, with longterm followup for the abdominal wound. The following photos illustrate the wittmann patch application as described in the use instructions and in the clinical literature by surgeons using it together with an adhesion preventing barrier the wittmann patch is also added to negative pressure dressing systems when these systems alone are not enough to achieve fascial closure. The use of the wittmann patch facilitates a high rate of fas. When the two fascial edges are close enough, the remaining patch material is removed and the abdominal wall closed fasciatofascia. A wittmann patch as used to close the abdominal wound.
Wittmann in 1987 while he was a professor of surgery at the university of hamburgs school of medicine in hamburg germany. The wittmann patch is opened at least once every 24 to 36 hours for dressing changes, procedures, inspections, and reapproximations. These included 19 trauma patients and 10 other surgical patients. The trademarks on file for companies that go by the name of starsurgical inc are starsurgical and wittmann patch. Deutsch owned 51% of star and was president of the company, and wittmann owned 49% and was vice president. The negative pressure dressings allowed active removal of fluid and. Starsurgicals wittmann patch trademark by a decision dated 10 july 2014. Several methods have been described to promote closure during the initial admission 5, 15, including the wittmann patch star surgical 16 and the vac devices 6,17. We are dedicated to the patients who trust that the medical professionals will perform to the best of their abilities. Wittmann patch ideally, primary closure should be achieved within 710 days, and it should be accomplished in the majority of open abdomens. Acs0706 operative exposure of abdominal injuries and. It is used for temporary bridging of abdominal wall openings where primary closure is not possible, andor repeat abdominal entries are necessary. History of the wittmann patch the wittmann patch, initially known as the artificial burr and star staged abdominal repair temporary wound cover, was developed by dr. Star surgicals is the newest member of the bmt medical devices.
Mar 30, 2005 if the surgeon places the patch without abdominal exploration, you should look instead to an appropriate integumentary system closure code for instance, 160, secondary closure of surgical wound or dehiscence, extensive or complicated, with modifier 58 appended. Institutional standards typically include, but are not limited to, patient monitoring, pain control, and antibiotic therapy. Located near chennai, design and manufacturing capabilities and is equipped with a modern stateofthe art facility for high volume production of precision plastic components to very high quality standards. Since 1991 the wittmann patch has been used in combination with hypopack to keep the wound sterile between abdominal. Tcis vision is to deliver innovative healthcare solutions and knowledge to our customers worldwide.
Aug 14, 2014 star cites wittmann s feeling of betrayal by deutsch, his removal of star s content from the. Converting from an elective surgical mindset to one of damage control can be very challenging. Staar surgical company was founded in 1982 with the goal of creating and manufacturing the worlds first foldable intraocular lens iol for cataract surgery. Jul 25, 2012 star patch by pamela chestek july 25, 2012 trademark i reported in the past about a dispute over the wittmann patch mark for a surgical device invented by mark wittmann. A bogota bag is a sterile plastic bag used for closure of abdominal wounds. Jul 25, 2015 in the 1993 wittmann described a new technique witmann patch, star surgical, burlington, vt consisting in two opposite velcro sheets sutured to the fascia and connected on the middle allowing an easy and fast access to the abdominal cavity, with a simple traction, and a stepwise reapproximation preventing the fascia retraction. Techniques for abdominal wall closure after damage control. As the company grew, it expanded its focus to include refractive surgery. Oct 18, 2017 there are 2 trademarks either applied for or owned by companies that go by the name of starsurgical inc. If the surgeon places the patch without abdominal exploration, you should look instead to an appropriate integumentary system closure code for instance, 160, secondary closure of surgical wound or dehiscence, extensive or complicated, with modifier 58 appended. If after several changes we are not making satisfactory progress with the vacuum dressing and serial closure, a wittmann patch star surgical inc. We will also redirect inquiries from families who join here because of posted items.
The world health organization who published the who surgical safety checklist and implementation manual in 2008 in order to increase the safety of patients undergoing surgery. He is the inventor of a fascia prosthesis for temporary abdominal closure, the artificial bur fascia prosthesis generic or wittmann patch and star patch. As surgeons began managing patients with open abdomens, many techniques were used for tacs table 4. May 24, 2011 he then went into business with wittmann, and in 1999 they secured fda approval and in 2000 formed starsurgical, inc.
Ewp2040 1 20 cm 40 cm loop sheet and 1 10 cm 40 cm hook sheet. Wittmann patch adjustable abdominal closure the wittmann patch is an adjustable hookandloop fascial closure tool for. Usmf members this section is dedicated to highlighting the items that have been returned to recipents owners or their families by our membership or items that forum members would like to attempt to return to the original recipentowner or families. Wittmann continued research on the wittmann patch fascia prosthesis in the department of surgery at the medical college of wisconsin. Surgical pictures 28, 11 courtesy of richard fantus, m. Over the next month, the fascial edges were gradually reapproximated in the icu. Jun 01, 2017 wittmann patch staged abdominal closure jordan a. Sg7 4 7 1 starguard suture retention plates per sterile pouch. The management of catastrophic abdominal injuries has been described in past military conflicts. The management of the open abdomen in trauma and emergency g. Tawt helps achieve abdominal wall closure without components separation or bridging mesh and preserves the leading edge of the fascial borders for final closure. A study has shown that delayed abdominal fascial closure dafc before 8 days was associated with fewer complications.
Delayed primary closure in damage control laparotomy. Examples include static traction devices like the wittmann patch star surgical inc, burlington, wi with its velcolike velcro industries b. Wittmann patch staged abdominal repair star the hookandloop wittmann patch is used for temporary bridging of abdominal wall openings where primary closure is not possible. Wittmann patch surgical technique video temporary abdominal closure techniques. Open abdomen in trauma and emergency general surgery.
Pdf technical options for suturing large wounds of the. Surgical mesh is a metallic or polymeric screen intended to be implanted to reinforce soft. Acs0706 operative exposure of abdominal injuries and closure of the abdomen. The options for tac are many and include the bogota bag, fashioned from a large intravenous fluid bag, a readytouse transparent bowel bag, vp technique, synthetic mesh absorbable or nonabsorbable, or a velcrotype sheath as advocated by wittmann et al. One of the initial references of the use of open abdomen technique was by ogilvie in 1940 during world war ii.
A couple of days later, he reopened the incision 49002 and placed a wittmann patch and a wound vac 97605. The use of the wittmann patch facilitates a high rate of. A proposed algorithm for managing the open abdomen. Evarrest the surgical patch helping surgeons johnson. He was associated with the following medical schools. Nov 10, 2016 when the active side of the patch comes into contact with the surface of bleeding tissue, thrombin a clotting enzyme converts the fibrinogen into fibrin. Of the six patients, five had thermal injury and one had electrical injury. The wittmann patch starsurgical, burlington, wi is a unique device which uses velcro to permit progressive abdominal closure without necessitating serial operations. The result is the formation of a stable blood clot that integrates with the patchs matrix design and sticks to the injured tissue surface to help stop the bleeding.
Tawt helps achieve abdominal wall closure without components separation or bridging mesh and preserves the leading. If you have a case where the patch has helped, or if you have comments or questions, we would welcome hearing from you. Surgical pictures 1, 9, 10 courtesy of mauricio miglietta, d. We are a liquidator of sutures and other surgical items from ethicon, covidien autosuture, synthes, stryker, arthrex and are able to pass our savings on to you. He then went into business with wittmann, and in 1999 they secured fda approval and in 2000 formed starsurgical, inc. Simplicity gold star applique clothing iron on patch, 3pc, 1.
A dodge that has twice helped me in a difficulty is the use of. Billing for repeated openings of wittmann patch general. This section will allow any member to post or list. Pdf on nov 27, 2012, jessica heimes and others published use of an abdominal reapproximation anchor abra system in a patient with abdominal compartment syndrome after severe burns. In the 1993 wittmann described a new technique witmann patch, star surgical, burlington, vt consisting in two opposite velcro sheets sutured to the fascia and connected on the middle allowing an easy and fast access to the abdominal cavity, with a simple traction, and a stepwise reapproximation preventing the fascia retraction. What cpt code would i use for a whittmann patch application. We hypothesized that use of the patch would result in a high closure rate. Reuse or reprocessing of the wittmann patch poses a significant risk of crosscontamination in terms of. In one series of 103 open abdomens managed with the wittmann patch, 78% of patients were able to have delayed primary closure compared with 30% of those who did not receive the patch p wittmann patch star surgical inc. Pdf use of an abdominal reapproximation anchor abra. Supercoder is powered by the experienced coding and compliance professionals at tci. Citeseerx delayed primary closure in damage control. Tawt pronounced taut is a technique to help close the acute open abdomen and reconstruct chronic giant ventral hernias. The wittmann patch requires use in accord with institutional standards for the critical care patients.
The open abdomen, indications, management and definitive. On 4 separate occasions after that, he opened the patch, inspected the abdominal cavity, performed lavage, closed the patch and reapplied the wound vac 97605. The purpose of this study was to determine the fascial closure rate using the wittmann patch. The tawt technique facilitates recapture of abdominal domain and fascial closure of acute and chronic giant ventral hernias without component separation, skin. A case report of delayed fascial closure by wittmann patch. Starsurgical will exchange any counterfeit product for the genuine wittmann patch quickly and at no cost. The wittmann patch is indicated for temporary bridging of abdominal wall overview surgical technique surgical technique video instructions for use.