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We are pleased with the many thoughtful comments and technical inquiries that have been made in response to our recent article.¹ In our initial report, we presented a modified technique to treat the vexing problem of an open abdomen. A review and comparison with other techniques of abdominal closure was outside of the scope of that report. Losanoff et al² have attempted to make such a comparison in a recent letter and have suggested that better alternatives may exist. We believe that their comments deserve a reply.

Sutureless vacuum-packing temporary abdominal closure has been used in our institution for many years. By itself, it does not prevent loss of abdominal domain. It should be noted that the so-called vac-pac dressing can be used in addition to dynamic retention closure to control abdominal fluid effluent and potentially reduce bacterial contamination of the abdominal cavity.

The Wittmann patch is an alterative method . . . [Full Text of this Article]

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