Assessment of a Non-invasive Device in the Management of Open Abdomen (AbCLO)
NCT ID: NCT06242925
Last Updated: 2025-04-25
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.
ACTIVE_NOT_RECRUITING
NA
20 participants
INTERVENTIONAL
2024-02-01
2025-12-31
Brief Summary
Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.
• Does the Abdominal Wall Closure Device (AbCLO) increase the likelihood of primary facial closure in cases of open abdomen when compared to historical controls?
Participants will be cases of open abdomen who underwent emergency surgery for Trauma or Acute Care Surgery, will have the AbCLO device. These will be compared to historical controls managed at the same center.
Related Clinical Trials
Explore similar clinical trials based on study characteristics and research focus.
Intrabdominal Pressure in Small Bowel Obstruction as a Possible Predictor for the Need of Operation
NCT01934283
Laparoscopy Versus Clinical Follow up to Detect Diaphragm Injury
NCT01044550
Early Small Bowel Obstruction Following Laparotomy For Trauma
NCT01068340
Natural Orifice Transgastric Endoscopic (NOTES) Transgastric Diagnostic Peritoneoscopy With Laparoscopic Assistance
NCT00962650
Laparoscopic Versus Open Appendectomy? Let the Patient Decide
NCT01738750
Detailed Description
Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.
The cohort (interventional) patients will receive the standard of care (Lahey bag, Ioban and closed suction drains) in addition to the study intervention (AbCLO Device).
The control group is retrospective patients that were previously managed at the same center, regardless of the technique or the device used to close the OA.
The total sample size is 80 patients, 20 in the treatment arm (15 from TMC and 5 from LAC+USC) and 60 in the control arm (45 from TMC and 15 from LAC+USC). The treatment arm will be matched to historical control based on the following pre-specified variables:
1. Age
2. Diagnosis: trauma case vs acute general surgery cases,
3. Assessment of severity: Injury severity scores (ISS) for Trauma cases and APACHEII score for acute general surgery cases
Outcome Data:
1. Primary Outcome: Proportion of patients achieved primary facial closure within 14 days. (This is defined as approximation of the fascia on either side of the midline to perform suture closure without using any mesh or additional procedures. From our experience, most open abdomen is usually closed within 7-10 days. We decided to put any closure more than 14 days is considered failure of the device).
2. Proportion of patients that require component separation and/or mesh closure to obtain fascial closure, (if we need to use mesh or do additional procedure to close the abdomen, this is considered failure rate of the ABCLO device)
3. Percentage of patients requiring additional device, such as Whitman's patch to maintain fascial closure. (this is also considered failure of the ABCLO device)
4. The time from inclusion to complete abdominal wall fascial closure (as defined above) prior to discharge. (Duration of patients that require the abdomen to be open)
5. Percentage of patients developing pressure ulcers (as a possible complication of the device)
6. Duration of mechanical ventilation, ICU length of stay and hospital length of stay (to examine the indirect effects of primary fascial closure on these outcomes)
7. Total cost per patient before and after application of the ABCLO from ICU admission to closure of the abdomen.
Conditions
See the medical conditions and disease areas that this research is targeting or investigating.
Study Design
Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.
NON_RANDOMIZED
SINGLE_GROUP
TREATMENT
NONE
Study Groups
Review each arm or cohort in the study, along with the interventions and objectives associated with them.
ABCLO Group
The cohort (interventional) patients will receive the standard of care (Lahey bag, Ioban and closed suction drains) in addition to the study intervention (AbCLO Device).
AbCLO (Abdominal Wall Closure) Device
They will receive the standard of care (Lahey bag covering the bowel, 2 drains in the subcutaneous tissue and Ioban covering everything). The AbClO device has two Rectus Muscle Splints (RMS) to stabilize the rectus abdominis (preventing buckling of these muscles and stabilize the circumferential dynamic retainer (CDR)). The CDR is passed behind the patient's back. The RMSs are positioned on the abdominal wall approximately 2 cm lateral to the wound edges on each side. Additional padding can be applied underneath the RMS. The CDR is passed between the cross bar and the locking strip of each RMS and stretched until taut. The locking strips are locked in position. Four tensioners bridge across the OA from one RMS to the other. Gauze packs should be interposed between the undersurface of the tensioners and the surface of the temporary abdominal coverage to prevent friction. The Tensioners are tightened progressively until complete facial closure.
Historical Controls
The control group is retrospective patients that were previously managed at the same center, regardless of the technique or the device used to close the OA.
At TMC, we have a previously collected data bank of all open abdomen managed at our center. This data bank is approved by IRB. This data bank has 170 patients in total. we will use 45 patients from the data bank to be matched to the interventional group (15 patients) to have a total of 60 patients from TMC.
As of LAC+USC Medical Center, they will provide historical controls from the trauma registry.
No interventions assigned to this group
Interventions
Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.
AbCLO (Abdominal Wall Closure) Device
They will receive the standard of care (Lahey bag covering the bowel, 2 drains in the subcutaneous tissue and Ioban covering everything). The AbClO device has two Rectus Muscle Splints (RMS) to stabilize the rectus abdominis (preventing buckling of these muscles and stabilize the circumferential dynamic retainer (CDR)). The CDR is passed behind the patient's back. The RMSs are positioned on the abdominal wall approximately 2 cm lateral to the wound edges on each side. Additional padding can be applied underneath the RMS. The CDR is passed between the cross bar and the locking strip of each RMS and stretched until taut. The locking strips are locked in position. Four tensioners bridge across the OA from one RMS to the other. Gauze packs should be interposed between the undersurface of the tensioners and the surface of the temporary abdominal coverage to prevent friction. The Tensioners are tightened progressively until complete facial closure.
Eligibility Criteria
Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.
Inclusion Criteria
2. Admitted to the trauma and acute care surgery service, underwent damage control laparotomy and left with an open abdomen (OA). Trauma or Emergency General Surgery, such as perforated viscus, Bowel obstruction or abdominal compartment syndrome.
Exclusion Criteria
2. Patients who lost any portion of the abdominal wall that preclude primary abdominal wall closure
3. Patient who previously had a ventral hernia before having an open abdomen
4. Patient who already had a previous mesh repair
5. Burn patients
18 Years
100 Years
ALL
No
Sponsors
Meet the organizations funding or collaborating on the study and learn about their roles.
InentoRR MD
UNKNOWN
LAC+USC Medical Center
OTHER
Tufts Medical Center
OTHER
Responsible Party
Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.
Principal Investigators
Learn about the lead researchers overseeing the trial and their institutional affiliations.
Mohammed A. Bawazeer, MD
Role: PRINCIPAL_INVESTIGATOR
Tufts Medical Center
Locations
Explore where the study is taking place and check the recruitment status at each participating site.
Los Angeles County + University of Sothern California Medical Center
Los Angeles, California, United States
Tufts Medical center
Boston, Massachusetts, United States
Countries
Review the countries where the study has at least one active or historical site.
References
Explore related publications, articles, or registry entries linked to this study.
Rezende-Neto J, Rice T, Abreu ES, Rotstein O, Rizoli S. Anatomical, physiological, and logistical indications for the open abdomen: a proposal for a new classification system. World J Emerg Surg. 2016 Jun 14;11:28. doi: 10.1186/s13017-016-0083-4. eCollection 2016.
Roberts DJ, Bobrovitz N, Zygun DA, Ball CG, Kirkpatrick AW, Faris PD, Stelfox HT. Indications for use of damage control surgery and damage control interventions in civilian trauma patients: A scoping review. J Trauma Acute Care Surg. 2015 Jun;78(6):1187-96. doi: 10.1097/TA.0000000000000647.
Karmali S, Evans D, Laupland KB, Findlay C, Ball CG, Bergeron E, Stewart TC, Parry N, Khetarpal S, Kirkpatrick AW. To close or not to close, that is one of the questions? Perceptions of Trauma Association of Canada surgical members on the management of the open abdomen. J Trauma. 2006 Feb;60(2):287-93. doi: 10.1097/01.ta.0000203579.62446.75.
Rezende-Neto JB, et al. Vaccum Pack technique for temporary abdominal wound closure. Rev Col Bras Cir 2007; 34:336-339.
Diaz JJ Jr, Cullinane DC, Dutton WD, Jerome R, Bagdonas R, Bilaniuk JW, Collier BR, Como JJ, Cumming J, Griffen M, Gunter OL, Kirby J, Lottenburg L, Mowery N, Riordan WP Jr, Martin N, Platz J, Stassen N, Winston ES. The management of the open abdomen in trauma and emergency general surgery: part 1-damage control. J Trauma. 2010 Jun;68(6):1425-38. doi: 10.1097/TA.0b013e3181da0da5.
Chen Y, Ye J, Song W, Chen J, Yuan Y, Ren J. Comparison of Outcomes between Early Fascial Closure and Delayed Abdominal Closure in Patients with Open Abdomen: A Systematic Review and Meta-Analysis. Gastroenterol Res Pract. 2014;2014:784056. doi: 10.1155/2014/784056. Epub 2014 Jun 2.
Miller RS, Morris JA Jr, Diaz JJ Jr, Herring MB, May AK. Complications after 344 damage-control open celiotomies. J Trauma. 2005 Dec;59(6):1365-71; discussion 1371-4. doi: 10.1097/01.ta.0000196004.49422.af.
Rezende-Neto JB, Rotstein OD. Abdominal catastrophes in the intensive care unit setting. Crit Care Clin. 2013 Oct;29(4):1017-44. doi: 10.1016/j.ccc.2013.06.005. Epub 2013 Aug 16.
Open Abdomen Advisory Panel; Campbell A, Chang M, Fabian T, Franz M, Kaplan M, Moore F, Reed RL, Scott B, Silverman R. Management of the open abdomen: from initial operation to definitive closure. Am Surg. 2009 Nov;75(11 Suppl):S1-22.
Kritayakirana K, M Maggio P, Brundage S, Purtill MA, Staudenmayer K, A Spain D. Outcomes and complications of open abdomen technique for managing non-trauma patients. J Emerg Trauma Shock. 2010 Apr;3(2):118-22. doi: 10.4103/0974-2700.62106.
Sagraves SG, Toschlog EA, Rotondo MF. Damage control surgery--the intensivist's role. J Intensive Care Med. 2006 Jan-Feb;21(1):5-16. doi: 10.1177/0885066605282790.
Dubose JJ, Lundy JB. Enterocutaneous fistulas in the setting of trauma and critical illness. Clin Colon Rectal Surg. 2010 Sep;23(3):182-9. doi: 10.1055/s-0030-1262986.
Scott BG, Feanny MA, Hirshberg A. Early definitive closure of the open abdomen: a quiet revolution. Scand J Surg. 2005;94(1):9-14. doi: 10.1177/145749690509400104.
Smith LA, Barker DE, Chase CW, Somberg LB, Brock WB, Burns RP. Vacuum pack technique of temporary abdominal closure: a four-year experience. Am Surg. 1997 Dec;63(12):1102-7; discussion 1107-8.
Sherck J, Seiver A, Shatney C, Oakes D, Cobb L. Covering the "open abdomen": a better technique. Am Surg. 1998 Sep;64(9):854-7.
Barker DE, Kaufman HJ, Smith LA, Ciraulo DL, Richart CL, Burns RP. Vacuum pack technique of temporary abdominal closure: a 7-year experience with 112 patients. J Trauma. 2000 Feb;48(2):201-6; discussion 206-7. doi: 10.1097/00005373-200002000-00001.
Dennis A, Vizinas TA, Joseph K, Kingsley S, Bokhari F, Starr F, Poulakidas S, Wiley D, Messer T, Nagy K. Not so fast to skin graft: transabdominal wall traction closes most "domain loss" abdomens in the acute setting. J Trauma Acute Care Surg. 2013 Jun;74(6):1486-92. doi: 10.1097/TA.0b013e3182924950.
Verdam FJ, Dolmans DE, Loos MJ, Raber MH, de Wit RJ, Charbon JA, Vroemen JP. Delayed primary closure of the septic open abdomen with a dynamic closure system. World J Surg. 2011 Oct;35(10):2348-55. doi: 10.1007/s00268-011-1210-8.
Rezende-Neto J, Al Kefeiri G, Semprun C, Rizoli S, Rotstein O. A non-invasive device for primary facial closure of the "open Abdomen" to prevent the "homeless bowel": a prospective, randomized, clinical tria abstract]. In: Proceedings of the Trauma Association of Canada 2017 Scientific Meeting & Conference; 2017 Feb 23-24, 2017; Vancouver (AB). Abstract 80.
Rezende-Neto JB, Camilotti BG. New non-invasive device to promote primary closure of the fascia and prevent loss of domain in the open abdomen: a pilot study. Trauma Surg Acute Care Open. 2020 Nov 11;5(1):e000523. doi: 10.1136/tsaco-2020-000523. eCollection 2020.
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
STUDY00003444
Identifier Type: -
Identifier Source: org_study_id
More Related Trials
Additional clinical trials that may be relevant based on similarity analysis.