Successful Re-Closure with Adjunctive Retention Sutures for Fascial Dehiscence after Mesh-Mediated Fascial Traction in Open Abdomen Management for Perforated Sigmoid Diverticulitis: A Case Report

Introduction

Open abdomen management (OAM) is sometimes required in patients with severe peritonitis and septic shock when primary fascial closure is unsafe or impossible. Mesh-mediated fascial traction (MMFT) combined with negative pressure wound therapy (NPWT) is a useful strategy for delayed fascial closure. However, fascial dehiscence may still occur after definitive closure in patients with multiple risk factors for impaired wound healing. Reports describing retention sutures as a salvage adjunct for fascial dehiscence after MMFT are scarce. We report a high-risk case in which re-closure with adjunctive retention sutures maintained abdominal wall closure after fascial dehiscence following staged closure.