Background: Abdominal wall skin and soft tissue defects that can not be closed primarily are termed complex abdominal wounds. These wounds are usually closed by an external synthetic mesh or a skin graft over exposed bowel, leaving a weak and vulnerable abdominal wall. In order to achieve a functional and aesthetic abdominal wound closure, the abdominal fascia must be tightly closed and the muscles and skin approximated. We present our experience in closure of complex abdominal wall defects with Wisebands, a novel skin and soft tissue-stretching device. The operating principle of these bands is based upon harnessing the visco-elastic properties of the skin and the stretching potential of the soft tissue, which under controlled mechanical load, can be stretched to a considerable degree within a short period of time.

Methods: During the past 3 years we operated on 6 patients with complex abdominal wounds using the Wisebands device. All the patients were referred to us by the general surgery division. All wounds were debrided, including the removal of old mesh pieces, with no encroachment on the peritoneal cavity. The Wisebands devices were applied to the wounds, stretching the skin and underlying fascia, gradually closing the defects until the edges were sufficiently approximated for primary closure.

Results:In 3 patients closure was achieved intra-operatively, and in 3 patients the wound edges were gradually approximated over 48 hours and then directly closed. In all the patients the abdominal wall wound was securely approximated, with no adverse sequels noted at the end of the process. One patient developed a small post-operative ventral hernia, with the skin completely closed and with no signs of dehiscence or infection. At a mean time of two-year follow-up (16 months – 3 years), stable scarring with no functional or significant aesthetic deficit was achieved.

Conclusion: Closure of complex abdominal wall defects is a surgical challenge that demands reliable closure of all abdominal wall layers. The use of the Wisebands is simple, with a short learning curve and provides the surgeon with a flexible tool to achieve solid closure while dealing with complex abdominal wall wounds.