<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03815370</url>
  </required_header>
  <id_info>
    <org_study_id>17-249</org_study_id>
    <nct_id>NCT03815370</nct_id>
  </id_info>
  <brief_title>A Non-Traumatic Binder for Temporary Abdominal Wall Closure</brief_title>
  <acronym>ABRO</acronym>
  <official_title>A Non-Traumatic Binder for Temporary Abdominal Wall Closure (ABRO) Multicentre Trial</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Unity Health Toronto</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Unity Health Toronto</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      At the end of most abdominal operations, the fascial layer is closed by stitching edges of&#xD;
      the wound together. However, because of logistic and/or technical reasons or the patient's&#xD;
      critical condition, the surgeon is forced to leave the abdomen open.&#xD;
&#xD;
      The current approach for temporary coverage of abdomen is vacuum assisted techniques (VAT).&#xD;
      This technique requires the use of vacuum-assisted drainage to remove blood or watery fluid&#xD;
      from a wound or operative site. Although this is the most successful and commonly used&#xD;
      procedure, there are some limitations to this method. For example, VAT have little effect on&#xD;
      preventing lateral movement of the wound edges. Therefore, VAT it is not the ideal procedure&#xD;
      in aiding surgeons to closed the abdomen.&#xD;
&#xD;
      The purpose of this study is to compare usual care (vacuum or non-vacuum methods for&#xD;
      temporary coverage of the OA) versus usual care plus a novel new abdominal binder device&#xD;
      called ABRO™ that may aid in the closure of patients who undergo open abdomen closure&#xD;
      procedures.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      At the end of most abdominal operations the fascial layer is closed primarily. However,&#xD;
      because of logistic, physiological and or anatomical reasons, the surgeon needs to leave the&#xD;
      abdomen open. In those circumstances, attempts to close the abdomen could potentially lead to&#xD;
      unnecessary damage to the abdominal wall fascia, intra-abdominal hypertension, abdominal&#xD;
      compartment syndrome and abdominal wall dehiscence post-operatively.&#xD;
&#xD;
      The use of the &quot;open abdomen&quot; (OA) in the post-operative period is not uncommon. Currently,&#xD;
      three important trends provide grounds for increased use of this surgical strategy:&#xD;
&#xD;
        -  Lifesaving surgical procedures in severely injured trauma patients.&#xD;
&#xD;
        -  Surgical procedures performed in patients with non-traumatic surgical emergencies&#xD;
&#xD;
        -  Abdominal catastrophes in elderly patients with pre-existing medical conditions. The OA&#xD;
           is not a new strategy in the surgeon's armamentarium. A recent publication retrieved&#xD;
           more than 1300 articles over the last 25 years relative to the management of the OA,&#xD;
           published in the English language.5 However, the precise incidence of the OA is unknown.&#xD;
           Nonetheless, hospitals around the world, particularly those that receive trauma victims,&#xD;
           have an OA rate of 1-5% among their most critically ill surgical patients.&#xD;
&#xD;
      This lifesaving surgical strategy does not come without a price. The mortality rate of an OA&#xD;
      is approximately 30%. There is also a wide range of complications linked to this procedure.&#xD;
      The OA exposes large surface area of the body to the environment increasing fluid losses.&#xD;
      Maintenance of adequate fluid and nutritional status of the patient are challenging in this&#xD;
      setting.&#xD;
&#xD;
      Furthermore, the exposed abdominal cavity also poses greater risk for local contamination&#xD;
      from external sources that could ultimately result in sepsis. Impaired abdominal wall&#xD;
      function interferes with ventilatory mechanics. Consequently, patients with OA are prone to&#xD;
      respiratory complications. However, the most dreaded complication of an OA is the formation&#xD;
      of an enteroatmospheric fistula (EF). The incidence of EF is approximately 11-15%, and&#xD;
      increases with time. Patients who have an OA for more than 8 days have an incidence of ECF as&#xD;
      high as 25%, caused mainly by damage to the exposed bowel. Management this complication is&#xD;
      extremely challenging, very costly, and carries a mortality rate of 36-64%.&#xD;
&#xD;
      In consideration of the foregoing considerations, early closure of the OA is undoubtedly the&#xD;
      most effective way to prevent complications linked to this lifesaving surgical strategy. One&#xD;
      of the most important barriers to early closure of the OA is lateral retraction of the&#xD;
      fascial wound edges. Retraction presents as early as three days post-operatively, involves&#xD;
      all layers of the abdominal wall and ultimately results in loss of domain. Moreover,&#xD;
      generalized edema, atrophy and contraction of the abdominal muscles also contribute to a&#xD;
      progressively larger defect in the fascia.Another important problem is &quot;buckling&quot; of the&#xD;
      rectus abdominal muscles resulting in a &quot;diamond&quot; shape defect in the fascial that is very&#xD;
      difficult to close.&#xD;
&#xD;
      Management of the OA prior to definitive closure call for temporary closure techniques. The&#xD;
      three main objectives of temporary closure techniques are to prevent injury to the bowel,&#xD;
      manage fluid loss from the abdominal cavity, and ultimately to facilitate primary closure.&#xD;
      Early closure is dependent on technical factors and patients' underlying clinical condition.&#xD;
      Despite all efforts to facilitate primary fascial closure, this condition is successfully&#xD;
      achieved only in approximately 60% of the cases.&#xD;
&#xD;
      Currently, vacuum assisted techniques (VAT) are the most frequent, and arguably the most&#xD;
      efficacious method for temporary coverage of the OA. Furthermore, VAT are particularly useful&#xD;
      in the management of edema fluid, gastrointestinal and peritoneal secretions. Despite these&#xD;
      important benefits, VAT provide minimal support to prevent lateral retraction of the&#xD;
      abdominal wall fascial edges. Indeed, vacuum closure devices are not able to brace the&#xD;
      abdominal wall and prevent lateralization of the rectus muscles even with maximum negative&#xD;
      pressure. Moreover, excessive negative pressure applied to the abdominal cavity could&#xD;
      potentially provoke severe injury to the intra-abdominal organs and interfere with&#xD;
      physiologic functions.&#xD;
&#xD;
      Devices applied surgically to the abdominal wall are more effective in preventing lateral&#xD;
      retraction of the fascial edges. However, these devices are stitched through the skin,&#xD;
      subcutaneous tissue, muscle, and fascial layers. These stitches frequently cut through the&#xD;
      aforementioned tissues because of the high pressure at the suture sites produced by&#xD;
      counteracting forces. The resulting wounds encompass all layers of the abdominal wall&#xD;
      including the fascia. Another important drawback of devices that require a surgical procedure&#xD;
      for application is the need for frequent trips to operating room for assessment and potential&#xD;
      adjustments. Furthermore, technical limitations inherit to surgically applied temporary&#xD;
      closure devices result in undesirable delay for the initial placement. A recent report showed&#xD;
      that the mean time from the primary operation to placement of the temporary closure device&#xD;
      was 9.5 days.16 This is dangerously close to the critical period of EF formation and loss of&#xD;
      abdominal domain.&#xD;
&#xD;
      Interim analysis of the data obtained from the initial randomized clinical trial to&#xD;
      investigate the original prototype of the non-traumatic binder for abdominal wall closure&#xD;
      (ABROTM) described in this protocol showed promising results (n=20 patients). The utilization&#xD;
      of the original prototype of the ABROTM device resulted in 80% primary fascial closure rate&#xD;
      compared to only 50% when VAT alone was employed. All patients (n=10) subjected to the&#xD;
      application of the original prototype of the ABROTM device had their abdomen closed by&#xD;
      primary fascial suture, without component separation or mesh. The ABROTM prototype resulted&#xD;
      in greater than 65% reduction in the maximum width and the area of the fascial defects at 4 ±&#xD;
      1 days post-operative, whereas VAT alone resulted in a 5% increase. Moreover, interim&#xD;
      analysis of the data showed that there were no complications from the use of the prototype of&#xD;
      the ABROTM device. Therefore, it is anticipated that the use of the new ABROTM device in the&#xD;
      proposed multicentre randomized controlled trial may have several advantages compared to&#xD;
      preexisting methods for closure of the OA&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Recruiting</overall_status>
  <start_date type="Actual">April 1, 2019</start_date>
  <completion_date type="Anticipated">March 30, 2023</completion_date>
  <primary_completion_date type="Anticipated">December 31, 2022</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <intervention_model_description>The purpose of this study is to compare usual care (vacuum or non-vacuum methods for temporary coverage of the OA) versus usual care plus the new abdominal binder device called ABRO™.</intervention_model_description>
    <primary_purpose>Treatment</primary_purpose>
    <masking>None (Open Label)</masking>
    <masking_description>It is impossible for the participant or anyone within the patients circle of care to be blinded in this study, as it is clear if the abdominal binder is on the participant or not. There is no way to blind in this interventional study.</masking_description>
  </study_design_info>
  <primary_outcome>
    <measure>Total number of patients who experience complete abdominal closure with sutures without the use of mesh and/or component separation.</measure>
    <time_frame>Outcome measures will record when closure of the abdomen takes place up to 11 days after randomization.</time_frame>
    <description>The primary outcome will measure the total number of patients who experience complete abdominal closure with sutures without the use of mesh and/or component separation.</description>
  </primary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Anticipated">140</enrollment>
  <condition>Abdominal Trauma</condition>
  <condition>Abdominal Injury</condition>
  <condition>Abdominal Infection</condition>
  <condition>Abdominal Sepsis</condition>
  <condition>Abdominal Abscess</condition>
  <condition>Abdominal Aneurysm</condition>
  <condition>Abdominal Compartment Syndrome</condition>
  <condition>Peritonitis</condition>
  <arm_group>
    <arm_group_label>Usual Care</arm_group_label>
    <arm_group_type>Placebo Comparator</arm_group_type>
    <description>The current approach for temporary coverage of abdomen is called &quot;vacuum assisted techniques (VAT)&quot;. This technique requires the use of vacuum-assisted drainage to remove blood or watery fluid from a wound or operative site.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Device: ABRO™Binder Arm</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Intervention is the usual care (listed above) plus a novel new abdominal binder device called ABRO™</description>
  </arm_group>
  <intervention>
    <intervention_type>Device</intervention_type>
    <intervention_name>Experimental: ABRO™ Binder Arm</intervention_name>
    <description>ABRO™ is an abdominal device designed to be positioned superficially on the abdominal skin of patients managed with the Open Abdomen strategy. The device is comprised of two rigid plates to stabilize the abdominal muscles thus preventing buckling of these. Another element of this novel device is the circumferential dynamic retainer (CDR). This one is passed behind the patient's back to provide more stability to the muscles in the abdomen keeping them in position to prevent lateral movement of them.</description>
    <arm_group_label>Device: ABRO™Binder Arm</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Device</intervention_type>
    <intervention_name>Placebo Comparator: Usual Care</intervention_name>
    <description>The current approach for temporary coverage of abdomen is called &quot;vacuum assisted techniques (VAT)&quot;. This technique requires the use of vacuum-assisted drainage to remove blood or watery fluid from a wound or operative site.</description>
    <arm_group_label>Usual Care</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Mechanically ventilated patients, managed with the OA strategy.&#xD;
&#xD;
          -  16 years of age or older&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Patients who are pregnant&#xD;
&#xD;
          -  Loss of any portion of the abdominal wall that could preclude primary closure&#xD;
&#xD;
          -  Burn patients&#xD;
&#xD;
          -  BMI greater than 40 kg/m2&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>16 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Joao Rezende-Neto, MD</last_name>
    <role>Principal Investigator</role>
    <affiliation>Unity Health Toronto</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Joao Rezende, MD</last_name>
    <phone>416-864-5284</phone>
    <email>Rezendenetoj@smh.ca</email>
  </overall_contact>
  <overall_contact_backup>
    <last_name>Sandy Trpcic</last_name>
    <phone>416-864-6060</phone>
    <phone_ext>7131</phone_ext>
    <email>TrpcicS@smh.ca</email>
  </overall_contact_backup>
  <location>
    <facility>
      <name>Royal Columbian Hospital</name>
      <address>
        <city>New Westminster</city>
        <state>British Columbia</state>
        <zip>V3L3W7</zip>
        <country>Canada</country>
      </address>
    </facility>
    <status>Not yet recruiting</status>
    <contact>
      <last_name>Vesna Ivkov</last_name>
      <email>vesna.ivkov@fraserhealth.ca</email>
    </contact>
    <investigator>
      <last_name>Michelle Goecke, MD, MSc</last_name>
      <role>Principal Investigator</role>
    </investigator>
  </location>
  <location>
    <facility>
      <name>Vancouver General Hospital</name>
      <address>
        <city>Vancouver</city>
        <state>British Columbia</state>
        <zip>V5Z1M9</zip>
        <country>Canada</country>
      </address>
    </facility>
    <status>Not yet recruiting</status>
    <contact>
      <last_name>Vahid Mehrnoush</last_name>
      <email>vahid.mehrnoush@vch.ca</email>
    </contact>
    <investigator>
      <last_name>Emilie Joos, MDCM</last_name>
      <role>Principal Investigator</role>
    </investigator>
    <investigator>
      <last_name>Naisan Garraway, CD, MD</last_name>
      <role>Principal Investigator</role>
    </investigator>
  </location>
  <location>
    <facility>
      <name>QEII Health Sciences Center</name>
      <address>
        <city>Halifax</city>
        <state>Nova Scotia</state>
        <zip>B3H3G1</zip>
        <country>Canada</country>
      </address>
    </facility>
    <status>Not yet recruiting</status>
    <contact>
      <last_name>Lisa Julien</last_name>
      <email>lisa.julien@nshealth.ca</email>
    </contact>
    <investigator>
      <last_name>Samuel Minor, MD</last_name>
      <role>Principal Investigator</role>
    </investigator>
  </location>
  <location>
    <facility>
      <name>St. Michael's Hospital</name>
      <address>
        <city>Toronto</city>
        <state>Ontario</state>
        <zip>M5B1W8</zip>
        <country>Canada</country>
      </address>
    </facility>
    <status>Recruiting</status>
    <contact>
      <last_name>Sandy Trpcic</last_name>
      <phone>416-864-6060</phone>
      <phone_ext>7131</phone_ext>
      <email>trpcics@smh.ca</email>
    </contact>
    <investigator>
      <last_name>Joao Rezende-Neto, MD, PhD</last_name>
      <role>Principal Investigator</role>
    </investigator>
  </location>
  <location_countries>
    <country>Canada</country>
  </location_countries>
  <verification_date>March 2022</verification_date>
  <study_first_submitted>November 22, 2017</study_first_submitted>
  <study_first_submitted_qc>January 23, 2019</study_first_submitted_qc>
  <study_first_posted type="Actual">January 24, 2019</study_first_posted>
  <last_update_submitted>March 8, 2022</last_update_submitted>
  <last_update_submitted_qc>March 8, 2022</last_update_submitted_qc>
  <last_update_posted type="Actual">March 10, 2022</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <keyword>Abdominal trauma/injury</keyword>
  <keyword>Abdominal sepsis/infection</keyword>
  <keyword>Open Abdomen</keyword>
  <keyword>Abdominal binder</keyword>
  <keyword>Abthera</keyword>
  <keyword>VAC</keyword>
  <keyword>ABRO</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Peritonitis</mesh_term>
    <mesh_term>Intraabdominal Infections</mesh_term>
    <mesh_term>Abdominal Abscess</mesh_term>
    <mesh_term>Compartment Syndromes</mesh_term>
    <mesh_term>Intra-Abdominal Hypertension</mesh_term>
    <mesh_term>Aortic Aneurysm, Abdominal</mesh_term>
    <mesh_term>Abdominal Injuries</mesh_term>
  </condition_browse>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03815370
org study id: 17-249
nct id: NCT03815370
lead sponsor: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
At the end of most abdominal operations, the fascial layer is closed by stitching edges of
      the wound together. However, because of logistic and/or technical reasons or the patient's
      critical condition, the surgeon is forced to leave the abdomen open.

      The current approach for temporary coverage of abdomen is vacuum assisted techniques (VAT).
      This technique requires the use of vacuum-assisted drainage to remove blood or watery fluid
      from a wound or operative site. Although this is the most successful and commonly used
      procedure, there are some limitations to this method. For example, VAT have little effect on
      preventing lateral movement of the wound edges. Therefore, VAT it is not the ideal procedure
      in aiding surgeons to closed the abdomen.

      The purpose of this study is to compare usual care (vacuum or non-vacuum methods for
      temporary coverage of the OA) versus usual care plus a novel new abdominal binder device
      called ABRO™ that may aid in the closure of patients who undergo open abdomen closure
      procedures.
At the end of most abdominal operations the fascial layer is closed primarily. However,
      because of logistic, physiological and or anatomical reasons, the surgeon needs to leave the
      abdomen open. In those circumstances, attempts to close the abdomen could potentially lead to
      unnecessary damage to the abdominal wall fascia, intra-abdominal hypertension, abdominal
      compartment syndrome and abdominal wall dehiscence post-operatively.

      The use of the "open abdomen" (OA) in the post-operative period is not uncommon. Currently,
      three important trends provide grounds for increased use of this surgical strategy:

        -  Lifesaving surgical procedures in severely injured trauma patients.

        -  Surgical procedures performed in patients with non-traumatic surgical emergencies

        -  Abdominal catastrophes in elderly patients with pre-existing medical conditions. The OA
           is not a new strategy in the surgeon's armamentarium. A recent publication retrieved
           more than 1300 articles over the last 25 years relative to the management of the OA,
           published in the English language.5 However, the precise incidence of the OA is unknown.
           Nonetheless, hospitals around the world, particularly those that receive trauma victims,
           have an OA rate of 1-5% among their most critically ill surgical patients.

      This lifesaving surgical strategy does not come without a price. The mortality rate of an OA
      is approximately 30%. There is also a wide range of complications linked to this procedure.
      The OA exposes large surface area of the body to the environment increasing fluid losses.
      Maintenance of adequate fluid and nutritional status of the patient are challenging in this
      setting.

      Furthermore, the exposed abdominal cavity also poses greater risk for local contamination
      from external sources that could ultimately result in sepsis. Impaired abdominal wall
      function interferes with ventilatory mechanics. Consequently, patients with OA are prone to
      respiratory complications. However, the most dreaded complication of an OA is the formation
      of an enteroatmospheric fistula (EF). The incidence of EF is approximately 11-15%, and
      increases with time. Patients who have an OA for more than 8 days have an incidence of ECF as
      high as 25%, caused mainly by damage to the exposed bowel. Management this complication is
      extremely challenging, very costly, and carries a mortality rate of 36-64%.

      In consideration of the foregoing considerations, early closure of the OA is undoubtedly the
      most effective way to prevent complications linked to this lifesaving surgical strategy. One
      of the most important barriers to early closure of the OA is lateral retraction of the
      fascial wound edges. Retraction presents as early as three days post-operatively, involves
      all layers of the abdominal wall and ultimately results in loss of domain. Moreover,
      generalized edema, atrophy and contraction of the abdominal muscles also contribute to a
      progressively larger defect in the fascia.Another important problem is "buckling" of the
      rectus abdominal muscles resulting in a "diamond" shape defect in the fascial that is very
      difficult to close.

      Management of the OA prior to definitive closure call for temporary closure techniques. The
      three main objectives of temporary closure techniques are to prevent injury to the bowel,
      manage fluid loss from the abdominal cavity, and ultimately to facilitate primary closure.
      Early closure is dependent on technical factors and patients' underlying clinical condition.
      Despite all efforts to facilitate primary fascial closure, this condition is successfully
      achieved only in approximately 60% of the cases.

      Currently, vacuum assisted techniques (VAT) are the most frequent, and arguably the most
      efficacious method for temporary coverage of the OA. Furthermore, VAT are particularly useful
      in the management of edema fluid, gastrointestinal and peritoneal secretions. Despite these
      important benefits, VAT provide minimal support to prevent lateral retraction of the
      abdominal wall fascial edges. Indeed, vacuum closure devices are not able to brace the
      abdominal wall and prevent lateralization of the rectus muscles even with maximum negative
      pressure. Moreover, excessive negative pressure applied to the abdominal cavity could
      potentially provoke severe injury to the intra-abdominal organs and interfere with
      physiologic functions.

      Devices applied surgically to the abdominal wall are more effective in preventing lateral
      retraction of the fascial edges. However, these devices are stitched through the skin,
      subcutaneous tissue, muscle, and fascial layers. These stitches frequently cut through the
      aforementioned tissues because of the high pressure at the suture sites produced by
      counteracting forces. The resulting wounds encompass all layers of the abdominal wall
      including the fascia. Another important drawback of devices that require a surgical procedure
      for application is the need for frequent trips to operating room for assessment and potential
      adjustments. Furthermore, technical limitations inherit to surgically applied temporary
      closure devices result in undesirable delay for the initial placement. A recent report showed
      that the mean time from the primary operation to placement of the temporary closure device
      was 9.5 days.16 This is dangerously close to the critical period of EF formation and loss of
      abdominal domain.

      Interim analysis of the data obtained from the initial randomized clinical trial to
      investigate the original prototype of the non-traumatic binder for abdominal wall closure
      (ABROTM) described in this protocol showed promising results (n=20 patients). The utilization
      of the original prototype of the ABROTM device resulted in 80% primary fascial closure rate
      compared to only 50% when VAT alone was employed. All patients (n=10) subjected to the
      application of the original prototype of the ABROTM device had their abdomen closed by
      primary fascial suture, without component separation or mesh. The ABROTM prototype resulted
      in greater than 65% reduction in the maximum width and the area of the fascial defects at 4 ±
      1 days post-operative, whereas VAT alone resulted in a 5% increase. Moreover, interim
      analysis of the data showed that there were no complications from the use of the prototype of
      the ABROTM device. Therefore, it is anticipated that the use of the new ABROTM device in the
      proposed multicentre randomized controlled trial may have several advantages compared to
      preexisting methods for closure of the OA
allocation: Randomized
intervention model: Parallel Assignment
intervention model description: The purpose of this study is to compare usual care (vacuum or non-vacuum methods for temporary coverage of the OA) versus usual care plus the new abdominal binder device called ABRO™.
primary purpose: Treatment
masking: None (Open Label)
masking description: It is impossible for the participant or anyone within the patients circle of care to be blinded in this study, as it is clear if the abdominal binder is on the participant or not. There is no way to blind in this interventional study.
measure: Total number of patients who experience complete abdominal closure with sutures without the use of mesh and/or component separation.
time frame: Outcome measures will record when closure of the abdomen takes place up to 11 days after randomization.
description: The primary outcome will measure the total number of patients who experience complete abdominal closure with sutures without the use of mesh and/or component separation.
arm group label: Usual Care
arm group type: Placebo Comparator
description: The current approach for temporary coverage of abdomen is called "vacuum assisted techniques (VAT)". This technique requires the use of vacuum-assisted drainage to remove blood or watery fluid from a wound or operative site.
arm group label: Device: ABRO™Binder Arm
arm group type: Experimental
description: Intervention is the usual care (listed above) plus a novel new abdominal binder device called ABRO™
intervention type: Device
intervention name: Experimental: ABRO™ Binder Arm
description: ABRO™ is an abdominal device designed to be positioned superficially on the abdominal skin of patients managed with the Open Abdomen strategy. The device is comprised of two rigid plates to stabilize the abdominal muscles thus preventing buckling of these. Another element of this novel device is the circumferential dynamic retainer (CDR). This one is passed behind the patient's back to provide more stability to the muscles in the abdomen keeping them in position to prevent lateral movement of them.
arm group label: Device: ABRO™Binder Arm
intervention type: Device
intervention name: Placebo Comparator: Usual Care
description: The current approach for temporary coverage of abdomen is called "vacuum assisted techniques (VAT)". This technique requires the use of vacuum-assisted drainage to remove blood or watery fluid from a wound or operative site.
arm group label: Usual Care
criteria: 
gender: All
minimum age: 16 Years
maximum age: N/A
healthy volunteers: No
last name: Joao Rezende-Neto, MD
role: Principal Investigator
affiliation: Unity Health Toronto
last name: Joao Rezende, MD
phone: 416-864-5284
email: Rezendenetoj@smh.ca
last name: Sandy Trpcic
phone: 416-864-6060
phone ext: 7131
email: TrpcicS@smh.ca
facility: 
status: Not yet recruiting
contact: 
investigator: 
facility: 
status: Not yet recruiting
contact: 
investigator: 
investigator: 
facility: 
status: Not yet recruiting
contact: 
investigator: 
facility: 
status: Recruiting
contact: 
investigator: 
country: Canada
responsible party type: Sponsor
mesh term: Peritonitis
mesh term: Intraabdominal Infections
mesh term: Abdominal Abscess
mesh term: Compartment Syndromes
mesh term: Intra-Abdominal Hypertension
mesh term: Aortic Aneurysm, Abdominal
mesh term: Abdominal Injuries