Repair of a laparostomy using biological mesh, topical negative pressure therapy and skin graft

The management of an open abdomen may present client and wound care challenges until the abdomen is closed1. This case study describes a client who had a laparostomy and extensive tissue debridement of the abdominal wall on a background of small bowel perforation, peritonitis and life-threatening sepsis. The abdomen remained open for over three weeks from initial emergency surgery prior to commencing repair of the abdominal wall with a biological mesh, Surgisis. Of interest was the concurrent use of topical negative pressure therapy (TNPT) with the biological mesh until the wound bed was suitable for a skin graft to complete wound closure. At the time, clinical practice guidelines or published literature to guide wound practice, in the context of the exposed biological mesh and TNPT, was not available and is therefore discussed.