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Aim Presentation of our data on Vacuum-Assisted Wound Closure and Permanent Onlay Mesh-Mediated Fascial Traction (VAWCPOM) in combination with Botulinum Toxin A (BTX-A) injection in the lateral abdominal wall as a treatment of the open abdomen (OA). Material and Methods This is a retrospective case series including patients treated for OA from January 2017 till March 2021 with VAWCPOM and BTX-A. Patient records were collected from medical charts, incl. age, sex, body mass index (BMI), comorbidity, initial fascial defect size, time until fascial closure, complications and, when available, outpatient follow-up. Results A total of 33 patients with OA were included. The mean age was 62,5 years, male/female ratio was 15:18, with a mean BMI of 35,4 kg/m2. The mean width of the fascial defect was 13,5 cm (5 - 25cm). The rate of fascial closure was 96,9%, achieved within a mean of 22,7 days. Fascial closure was not attainable in one patient who developed enterocutaneous fistula under treatment. 22 patients experienced in-hospital complications. Short-term follow-up was conducted in 22 patients, with hernia recurrences in three. Conclusions Treatment of OA remains a surgical challenge. This case series shows promising results with a high rate of fascial closure using a combination of VAWCPOM and BTX-A and an acceptable rate of postoperative complications in this severely challenging patient group. The rate of primary closure indicates that this may be the future management of open abdomen.

british journal of surgery

P128 BOTULINUM TOXIN A IN CONJUNCTION WITH NEGATIVE PRESSURE WOUND THERAPY AND MESH-MEDIATED FASCIAL TRACTION PROVIDES HIGH RATE OF FASCIAL CLOSURE IN PATIENTS WITH OPEN ABDOMEN