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Choose an evidence-based TAC system.
3M™ AbThera™ Open Abdomen Negative Pressure Therapy
Whether your patient has experienced a traumatic injury or requires sepsis management, the method of temporary abdominal closure you choose may play an important role in positive clinical and economic outcomes.1
AbThera™ Therapy combines a proprietary foam dressing and drape with negative pressure therapy to manage the open abdomen. In two separate studies, AbThera Therapy demonstrated greater reduction in 30-day1 and 90-day2 all-cause mortality when compared to Barker's vacuum packing technique.
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20-30% of open abdomen patients are not able to achieve primary fascial closure.3
Patients in whom early definitive primary closure cannot be performed are more likely to experience:4
- Infectious complications and sepsis
- Increased ICU and hospital length of stay (LOS)
- Increased duration (days) of mechanical ventilation
- Acute kidney injury
- Enteroatmospheric fistula (EAF)
- Fascial retraction with loss of abdominal domain
- Large incisional hernia
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Patient-centered science designed to manage and protect
AbThera Therapy helps to achieve primary fascial closure. Through our patient-centered science, we know that achieving fascial closure within 4–7 days of treatment is associated with lower mortality and fewer complications like sepsis, fistulas, and hernia.5
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AbThera Therapy demonstrated greater reduction in 30-day and 90-day all-cause mortality versus Barker’s vacuum pack technique (BVPT)
In the first of two studies, when compared to Barker’s vacuum packing technique, AbThera Therapy demonstrated greater reduction in 30-day1 and 90-day2 all-cause mortality. A combined total of 325 patients received temporary abdominal closure (201 AbThera Therapy, 124 BVPT). 30-day all-cause mortality was 14% for AbThera Therapy and 30% for BVPT (p = 0.01).1
In the second study, 45 patients with abdominal injuries or intra-abdominal sepsis were randomly allocated to AbThera Therapy (n = 23) or Barker’s vacuum pack (n = 22). 90-day all-cause mortality was 21.7% for AbThera Therapy and 50% for BVPT (p = 0.04).2 Primary endpoint to identify the difference in plasma concentration of interleukin-6 at 24- and 48-hours after application were not met.
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Per-patient hospital charges averaged $160,275 lower with AbThera Therapy6
In a 42-patient study analysing resource utilization for patients receiving TAC, AbThera Therapy (n=30) was compared with BVPT (n=12). Information regarding complications and resource utilisation was collected and analysed.
Results showed AbThera Therapy patients, on average, required fewer dressing changes than the BVPT group (2 versus 3, respectively; p=0.047).
And, hospital charges were, on average, $454,081 in the BVPT group versus $293,806 (35% less) in the AbThera Therapy group (p=0.11).**This calculation was based on comparative 30-day all-cause mortality rates reported in this study.
Dressings for AbThera Therapy
AbThera Therapy uses these specialised dressings with the 3M™ V.A.C.® Ulta Therapy Unit to actively remove fluid and help reduce oedema in an open abdomen.
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Specifically designed for the management of the open abdomen3M™ AbThera™ Open Abdomen Negative Pressure Therapy incorporates all the functional elements of an ideal temporary abdominal closure device . The components form a synergised system designed for simplicity, ease of use, and fast applications.
Explore AbThera SensaT.R.A.C. dressing kit
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This dressing includes a redesigned dressing configuration for drawing wound edges together, directly based upon the technology and success of 3M™ AbThera™ Open Abdomen Negative Pressure Therapy.
How does AbThera Therapy work?
AbThera Therapy incorporates all the functional elements of an optimal TAC device. The components form a synergised system designed for simplicity, ease of use and fast application.1 Continuous negative pressure is transferred from the therapy unit to the perforated foam and to the encapsulated foam within the visceral protective layer. It can remove fluids from the abdominal cavity, draw fascial edges together, and protect abdominal contents from external contaminants.
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Actively removes fluid
AbThera Therapy provides an active temporary abdominal closure system, designed to remove fluids, draw wound edges together and help to achieve primary fascial closure while protecting abdominal contents.7,1
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Provides separation and protection
The 3M™ AbThera™ Fenestrated Visceral Protective Layer provides separation between the abdominal wall and viscera, and it protects abdominal contents. The 3M™ V.A.C.® Drape further isolates the bowel and other abdominal contents from the external environment.
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Applies medial tension
Perforated foam dressings collapse medially, drawing fascial edges closer together. The medial tension helps minimise fascial retraction and loss of domain.1,3,8
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Designed for ease of use and fast applications
AbThera Therapy allows for rapid access for re-entry and does not require sutures for placement. It gives you quick access to a patient’s abdomen to facilitate re-exploration or washouts.9
"More than 85% of open abdomens are actually for non-trauma patients and so all the benefits we see from using 3M™ AbThera™ Therapy in trauma patients, meaning protecting the viscera, easy access back in, quick look operations. Those spill over to the acute care or urgent surgery or emergent surgery patient just as well.”
Comparing TAC techniques4,10
The alternative TAC methods all compromise one or more of the core pillars of open abdomen management (protection from the external environment, fascial approximation and fluid management). They may reduce the likelihood of fascial reapproximation, or increase risk of fistula development, or may fail to remove fluid from the paracolic gutters, all of which are common complications in patients with exposed viscera.
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Case study excerpt on abdominal fascial closure
Use of 3M™ AbThera™ Advance Open Abdomen Dressing for abdominal fascial closure
A 24-year-old female presented to the Emergency Department with complaints of abdominal and back pain, dizziness and near syncopal episode but no nausea or vomiting. She was noted as afebrile, tachycardic (140 beats per minute [bpm]), and hypotensive (systolic blood pressure in the 60’s mmHg). On physical examination, she had left lower quadrant tenderness. A continuous wave, obstetrical Doppler ultrasound revealed an early intrauterine pregnancy (11-week gestation) and a fetal heart rate of 135 bpm. She had leukocytosis (18.9) and a neutrophil count of 84.
Ringer’s lactate solution was administered intravenously for her hypotension, and she remained tachycardic (> 120 bpm). A Focused Assessment with Sonography for Trauma (FAST) detected free fluid in the pelvis and right upper quadrant. The patient was anemic (hemoglobin = 6.8), which raised concern for intraabdominal bleeding of unknown origin and prompted a general surgery consult.
An abdominal computed tomography (CT) scan revealed dilated loops of small bowel but diffuse thickness consistent with edema and a fluid-filled abdominopelvic cavity. Given her hemodynamic instability and CT scan, she was taken to the operating room (OR) for diagnostic laparoscopy to explain her clinical decompensation.
The patient underwent diagnostic laparoscopy that was converted to an open exploration after scope insertion revealed bloody ascites and loops of necrotic small bowel. An internal hernia defect facilitated volvulisation of the small bowel, which required intestinal detorsion and prompted a resection of 300 cm of ischemic small bowel. The bowel was left in discontinuity and AbThera Advance Dressing was placed within the open abdomen for temporary closure.
On postoperative day 2, the patient returned to the OR for 3M™ AbThera™ Advance Open Abdomen Dressing removal; abdominal lavage; a stapled, jejunal-colonic, end-to-end anastomosis; appendectomy; placement of a nasoenteric tube and fascial closure. She was discharged on hospital day 7. In this case, AbThera Advance Dressing helped facilitate fascial closure and helped prevent abdominal retraction.
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A) AbThera Advance Dressing placement after small bowel resection (patient in supine position)
B) AbThera Advance Dressing placement after small bowel resection.Patient data and photos courtesy of Marc R. Matthews, MD, MS, FACS, Associate Director, Arizona Burn Center, Director, Burn Emergency Services Director, Respiratory Care Services, Maricopa Medical Center.
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NOTE: As with any case study, the results and outcomes should not be interpreted as a guarantee or warranty of similar results. Individual results may vary depending on the patient’s circumstances and condition.
Application and resource guides for AbThera Therapy
Helping you develop your skills
Discover online learning that's right for you and deepen your clinical expertise with training opportunities and educational resources available on the 3M℠ Health Care Academy. 3M webinars and archived events can help keep you up to date with the latest product guidelines and scientifically supported standards of care.
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Explore additional 3M Negative Pressure Wound Therapies
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Prevena Therapy is the first single-use negative pressure therapy system designed for the management of closed incisions in patients at risk of postoperative complications, including infection.
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3M™ V.A.C.® Therapy has been shown to be a successful way to manage wounds for the past 25 years.11 It can be used to reduce hospitalization time and the risk of complications,11,12 which in turn helps facilitate patient transitions from inpatient to outpatient care settings.
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Veraflo Therapy combines the benefits of NPWT with automated instillation and dwell of topical wound solution to provide simultaneous cleansing and granulation tissue formation.*13,14
*Results have not been confirmed in human studies.
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Snap Therapy is a discreet, single-use system that preserves patient mobility and is ideal for low-to-moderate exuding wounds.
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Looking for more information?
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We are here to help! Get in touch with our customer support team for advice about our products and how to use them.
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View our advanced wounds and Negative Pressure Wound Therapy and I.V. dressings portfolios and browse our product catalogue.
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Find Instructions for Use for specific 3M Health Care products.
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Find answers to the most frequently asked questions regarding 3M Health Care.
NOTE: Specific indications, contraindications, warnings, precautions and safety information exist for these products and therapies. Please consult a physician and product instructions for use prior to application. This material is intended for healthcare professionals.
References
- Cheatham ML, et al. Prospective Study Examining Clinical Outcomes Associated with a Negative Pressure Wound Therapy System and Barker’s Vacuum Packing Technique. World Journal of Surgery. 2013 Sep;37(9):2018-30.
- Kirkpatrick AW, Roberts DJ, Faris PD et al. Active Negative Pressure Peritoneal Therapy After Abbreviated Laparotomy: The Intraperitoneal Vacuum Randomized Controlled Trial. Ann Surg 2015;262(1):38-46.
- Atema JJ, Gans SL, Boermaster MA. Systematic Review and Meta-analysis of the Open Abdomen and Temporary Abdominal Closure Techniques in Non-trauma Patients. World J Surg. 2015;39(4):912-925.
- Fitzpatrick ER. Open abdomen in trauma and critical care. Critical Care Nurse. 2017 Oct 1;37(5):22-45.
- Chen Y, Ye J, Song W, Chen J, Yuan Y, Ren J. Comparison of outcomes between early fascial closure and delayed abdominal closure in patients with open abdomen: a systematic review and meta-analysis. Gastroenterol Res Pract. 2014;2014:784056
- Safcsak K, Cheatham ML. ABTHERA™ Open Abdomen Negative Pressure System versus Barker’s Vacuum Pack Technique: analysis of resource utilization. Poster presented at the Fifth World Congress on the Abdominal Compartment, Orlando, FL. August 10-13, 2011.
- Schmidt M, Hall C, Mercer D, Kieswetter K. Novel foam design actively draws wound edges together under negative pressure: benchtop and pre-clinical assessment [abstract]Schmidt M, Hall C, Mercer D, Kieswetter K. Presented at the SAWC Fall 2018 Meeting, November 2-4, 2018, Las Vegas, Nevada 2018
- Frazee RC, Abernathy SW, Jupiter DC, et al. Are Commercial Negative Pressure Systems Worth the Cost in Open Abdomen Management? J Am Coll Surg. 2013 April 1;216(4):730-3
- Campbell A, Chang M, Fabian T et al. Management of the open abdomen: from initial operation to definitive closure. Am Surg 2009 November 1;75(11 Suppl):S1-S22.
- Huang Q, Li J, Lau WY. Techniques for Abdominal Wall Closure after Damage Control Laparotomy: From Temporary Abdominal Closure to Early/Delayed Fascial Closure-A Review. Gastroenterol Res Pract. 2016;2016:2073260.
- Law A L Krebs B. Karnik B. Griffin L. Comparison of Healthcare Costs Associated With Patients Receiving Traditional Negative Pressure Wound Therapies in the Post Acute Setting. Cureus 12(11): e11790. DOI 10.7759/cureus.11790.v
- Page JC, Newsander B, Schwenke DC, Hansen M, Ferguson J. Retrospective analysis of negative pressure wound therapy in open foot wounds with significant soft tissue defects. Adv Skin Wound Care/ 2004;17(7):354-364.
- Lessing C, Slack P, Hong KZ, Kilpadi D, McNulty A. Negative Pressure Wound Therapy With Controlled Saline Instillation (NPWTi): Dressing Properties and Granulation Response In Vivo. Wounds. 2011 Oct;23(10):309-19.
- Carroll C, Ingram S, Comparison of Topical Wound Solutions for Negative Pressure Wound Therapy with Instillation: Effect on Granulation in an Excisional Non-Infected Acute Porcine Wound Model, Poster Presentation at SAWC, Oct 2017.
