ABRA® Surgical Skin Closure

Today’s Standard of Care Patch the defect Retracted wounds are commonly covered rather than restored, even when there is no skin loss, leaving visible and often debilitating defects (E.g. Skin Graft)

Patching with a skin graft instead of primarily closing it Up to 16% graft failure rates Two wounds instead of one! Leaves cosmetically poor, often debilitating defects (2 not 1!) Left Photo: Infected graft that didn’t take Middle: Donor site – often left more sensitive than the patched site! Equivalent in pain to a second degree burn and sensitive for up to a year Right: Patching – cosmetically & functionally substandard results! Grafts often bond to muscle since fascia coverage is missing.

Case Study -Jacob’s Ladder Vessel Loop & Staple Method A number of surgeons still use this method because they intuitively know that a dynamic closure force rather than a static one is key to wound closure. Of course, each surgeon feels he invented this technique. You can use this fact to your advantage – he already believes in DWC, you’ve got a proven system that’s more patient friendly, easier for the surgeon to adjust, and the nurses to maintain. This method was actually the reason for our ABRA Surgical Skin Clsoure set – Canica set out to simply make a superior mousetrap and … we did! The surgeon knows the short coming of this method, so focus on our features. Wound edge eversion, set back to leave well vascularized margins, easy to adjust, and very elastic, much more so than vessel loops.

Day 12

ABRA Surgical Skin Closure Eliminates Skin Grafts ABRA® Surgical Skin Closure is indicated for closure of retracted skin defects including, but not limited to, fasciotomies, compound fracture wounds and abdominal skin closure over mesh or hernia.

ABRA Surgical Skin for Fasciotomy closure A fifteen-year-old male gymnast was hospitalized with complicated fracture of the tibia. Twenty-four hours after bone fixation, he developed acute compartment syndrome. The ABRA Surgical Skin Closure System was installed one day after the resulting fasciotomy. Fasciotomy, complicated fracture of the tibia

Post Installation

Day 5: Closure by sutures, ABRA removed Day 10: Sutures removed

ABRA for FASCIOTOMY CLOSURE “we’ve taken the bugs out of Jacobs Ladder.” In comparison ABRA is: much more elastic distributes the load to avoid skin damage everts margins to avoid granulation easily adjusted achieves primary closure, consistently. 12

ABRA Surgical Skin Closure Benefits Achieves Primary Closure Normalizes compartment pressures Restores normal skin integrity Closes wounds in 3-6 days Eliminates skin grafts Features Promotes patient mobility Reduces OR visits Reduces hospital length of stay and costs Reduces homecare expenses

ABRA: Surgical Skin “We were able to close fasciotomies in an average 2.6 days - several times faster than other techniques. Overall, we do believe that this [ABRA Surgical Skin Closure system] is a superior technique.” Dr. Niten Singh Madigan Army Medical Center, Tacoma, WA

ABRA for ABDOMINAL SKIN CLOSURE Week 1 Week 3 Week 6

DYNAMIC WOUND CLOSURE INDICATIONS Dynamically close retracted open wounds (abdominal, fasciotomies, sternotomy) Dynamic maintenance system to prevent open wounds from further retraction (When high risk of Sepsis is present) Dynamic external system to pre-surgically stretch skin creating skin deport prior to skin excision surgery when DynaClose is not indicated Dynamically support closed primary incisions that are under high tension and cosmesis when SutureSafe is not indicated

FINANCIAL IMPLICATIONS TO USING ABRA Surgical Skin System Primary closure of fasciotomies reduced cost by $8,062 per patient compared to skin graft repair in Ottawa hospital review in 2002/03