1. ABRA® Surgical Skin Closure

2. 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)

3. 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.

4. 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.

7. Day 12

8. 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.

9. 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

10. Post Installation

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

12. 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

13. 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

14. 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

15. ABRA for ABDOMINAL SKIN CLOSURE
Week 1
Week 3
Week 6

17. 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

18. 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