pp 1–7 | Cite as

Novel method for delayed primary closure and incisional hernia prevention in open abdomen: COmbined and MOdified Definitive Abdominal wall closure (COMODA)

  • R. Villalobos MoriEmail author
  • Y. Maestre González
  • Mª Mias Carballal
  • C. Gas Ruiz
  • G. Protti Ruiz
  • A. Escartin Arias
  • J. J. Olsina Kissler



Intended open abdomen is an option in cases of trauma and non-trauma patients. Nevertheless, after primary closure, incisional hernia rate is high. We describe a novel method, called COmbined and MOdified Definitive Abdominal closure (COMODA), a delayed primary closure which prevents incisional hernia.


A negative pressure wound therapy system is combined with a condensed polytetrafluoroethylene (cPTFE) mesh. Trial registration: ISRCTN72678033.


Ten male patients with a median age of 68.8 (43–87) years were included. Primary closure rate was 100% per protocol. The median number of procedures per patient was 5.7 (5–9). Primary closure was obtained in 20.8 (10–32) days and median hospital stay was 36.3 (18–52) days. Only one patient developed incisional hernia during a median follow-up of 27 (8–60) months.


COMODA method allows for a high rate of delayed primary closure. It is safe and decreases the risk for developing an incisional hernia. However, a large number of patients are needed to support this conclusion.


Open abdomen Incisional hernia Primary closure Intra-abdominal pressure 


Compliance with ethical standards

Conflict of interest

The authors of this manuscript have no conflicts of interest to disclose. RV declares no conflict of interest. YM declares no conflict of interest. MM declares no conflict of interest. CG declares no conflict of interest. GP declares no conflict of interest. AE declares no conflict of interest. JO declares no conflict of interest.

Ethical statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Statements of human and animal rights

This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Abdominal Wall Surgery Unit, General Surgery Department, Arnau de Vilanova University HospitalLleida UniversityLleidaSpain

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