# US 2014/0155935 A1 · Method and apparatus for surgically closing an open abdomen > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2014/0155935 A1 - Document ID: US20140155935A1 - Status: Published application - Kind: A1 - Application number: 14/173,603 - Filed: 2014-02-05 - Published: 2014-06-05 - Earliest claimed: 2010-07-30 - Inventors: Andrew Dennis - Web page: https://patentgrep.com/patent/US20140155935A1 ## CPC - A61B 17/08: Wound clamps {or clips, i.e. not or only partly penetrating the tissue (suture bridges A61B17/0466); Devices for bringing together the edges of a wound} - A61B 17/06166: {Sutures (suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M)} - A61F 17/00: First-aid kits - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C) ## Abstract An open abdomen wound as a result of injury or surgery is closed using hook and loop fastener sheets that are attached at opposing edges of the wound using bolsters through which surgical suture threat is passed to secure the abdominal wall between the fastener sheets and the bolsters. Tension forces are exerted on the fastener sheets and the sheets secured to one another in one or more steps drawing the wound edges toward one another. The tension forces are distributed by the bolsters to avoid loss of tissue at the wound edges. Successful closure of the wound is possible. ## Claims ### Claim 1 A method for closing an open abdomen wound, comprising the steps of: positioning a first bolster along a first edge of the abdominal wound; securing a first fastener sheet to the first edge of the wound by suturing through the first fastener sheet and through the abdominal wall and through the first bolster to secure the abdominal wall between the first fastener sheet and the first bolster; positioning a second bolster along a second edge of the abdominal wound; securing a second fastener sheet to the second edge of the wound by suturing through the second fastener sheet and through the abdominal wall and through the second bolster to secure the abdominal wall between the second fastener sheet and the second bolster; applying tension to at least one of said first and second fastener sheets to draw the first and second edges of the wound toward one another; attaching said first fastener sheet to said second fastener sheet while under tension so as to apply static tension to opposing sides of the abdominal wound; repeating said steps of applying tension to at least one of said first and second sheets and attaching said first and second sheets to one another as needed to draw the first and second edges of the wound in proximity; and surgically closing the abdominal wound by suturing the first and second edges to one another. ### Claim 2 (depends on 1) A method as claimed in claim 1, wherein said first and second fastener sheets include a hook fastener sheet and a loop fastener sheet. ### Claim 3 (depends on 1) A method as claimed in claim 1, further comprising the steps of: applying a hydrocortoid sheets on skin of the abdomen; and wherein said step of positioning the bolsters positions the bolsters on the hydrocortoid sheets. ### Claim 4 (depends on 1) A method as claimed in claim 1, wherein said step of positioning said bolsters follows positioning of the first and second fastener sheets. ### Claim 5 (depends on 1) A method as claimed in claim 1, where said bolsters are positioned at or adjacent a patient's rectus muscles. ### Claim 6 (depends on 1) A method as claimed in claim 1, wherein steps of securing the first and second fastener sheets includes suturing through all layers of the abdominal wall. ### Claim 7 (depends on 1) A method as claimed in claim 1, wherein said step of steps of securing said first and second fastener sheets includes the sub-steps of: sewing a suture: through a first opening in a first of said bolsters, through the abdominal wall, through the fastener sheet at a first location, back through the fastener sheet at a second location, back through the abdominal wall, and through a second opening in said first bolster that is spaced from said first opening; tying ends to said suture that extends from the first opening and from said second opening to one another to form a loop of suture affixing the fastener sheet to the bolster through the abdominal wall; repeating the sewing and tying steps at further pairs of openings in the first bolster to form loops of suture along a length of the first bolster; and repeating the sewing and tying steps with a second bolster. ### Claim 8 (depends on 7) A method as claimed in claim 7, wherein said first bolster is formed of a soft inner material and a hard outer material, and wherein said step of tying the ends of the suture positions in a knot of suture that is on the hard outer material of the first bolster. ### Claim 9 (depends on 7) A method as claimed in claim 7, wherein said loops of suture are substantially evenly spaced along a length of the bolster. ### Claim 10 A kit for use in closing an abdominal wound, comprising: first and second fastener sheets for selective engagement with one another; a plurality of bolsters, each bolster being an elongated strip defining a plurality of holes along its length, each bolster having a relatively rigid strip portion and a cushioning portion attached to said rigid strip portion; a viscera protective barrier sheet; and a skin protective barrier. ### Claim 11 (depends on 10) A kit as claimed in claim 10, wherein said viscera protective barrier sheet includes a polyurethane soft visceral protection barrier ### Claim 12 (depends on 10) A kit as claimed in claim 10, wherein said skin protective barrier includes hydrocolloid adhesive dressings. ### Claim 13 (depends on 10) A kit as claimed in claim 10, wherein said bolsters each have an elongated rigid plastic strip having the holes formed therein and an elongated foam strip affixed to said elongated rigid strip. ### Claim 14 (depends on 10) A kit as claimed in claim 10, wherein said bolsters each have an elongated metal strip having the holes formed therein and an elongated foam strip affixed to said elongated rigid strip. ### Claim 15 (depends on 14) A kit as claimed in claim 14, wherein said metal strip is formed of aluminum. ### Claim 16 (depends on 10) A kit as claimed in claim 10, wherein said first and second fastener sheets include a hook fastener sheet and a loop fastener sheet. ### Claim 17 A method for stretching retracted lateral muscles of a patient's abdomen, comprising the steps of: positioning bolsters on the patient's abdomen; affixing first and second fastener sheets to said bolsters, said affixing step including suturing through at least portions of the patient's abdominal wall and through the fastener sheets and through the bolsters; exerting a tension force on at least one of said fastener sheets; and fastening said fastener sheets to one another so as to exert a static tension force on the lateral muscles of the patient's abdomen. ### Claim 18 (depends on 17) A method as claimed in claim 17, further comprising the step of: repeating the steps of exerting a tension force and fastening said fastener sheets to further stretch the retracted lateral muscles. ### Claim 19 (depends on 17) A method as claimed in claim 17, further comprising the step of: surgically closing an open abdomen after stretching the retracted lateral muscles of the patient's abdomen.