Improving vacuum-assisted closure of widely open abdomens with improvised elastic sutures

Widely dehisced abdominal wounds present as challenging surgical cases often incurring multiple complications such as bowel desiccation, perforation, and enterocutaneous fistula [1], equating a mortality of 25% [2]. With the extensive usage of topical negative pressure dressings, these complications have reduced. However these abdomens are now presenting as open wounds with incarcerated edges, necessitating skin grafting on bowel. We present an effective approach to the closure of open abdomens using a combination of topical negative pressure and elastic sutures improvised from silicone tubing. The elastic sutures stretch the skin and prevent wound edges from bedding down prematurely, thereby allowing primary closure.