LAUSR

In some settings, it is not appropriate to close wounds primarily, such as when patients are felt to be at high risk for wound infection. FFT is a useful method of wound closure in these patients following open AWR. A consecutive series of patients were closed with FFT following AWR from 2019–2022. The FFT includes cutting a vacuum-assisted closure (VAC) sponge into 1×1×8cm segments that are partially placed through an otherwise closed wound. A skin VAC is placed over the wound and external portion of the FFs. Patient characteristics, operative details, and postoperative outcomes were collected. Standard descriptive statistics were reported. Wound closure was performed with FFT in 15 patients. Patients were 63.8±13.1 years old, mean BMI was 31.1±6.5 kg/m2, and there was history of tobacco use in 40.0% of patients, diabetes in 46.7%, and prior failed hernia repair in 11(73.3%). Almost all had CDC wound class of 3 or 4(13, 86.7%) wounds, and hernia defect size was 144[8, 310]cm2. Biologic mesh was placed in 9(60.0%), and no mesh was used in 6(40.0%). Wound complication risk based on the CeDAR risk score was 59.5±15.1%. There were 2(13.3%) 30-day readmissions, including 1(6.7%) for a wound infection that was reopened at the bedside. There were no other wound complications. FFT is an alternative method of wound closure for significantly at-risk wounds in patients undergoing AWR. The present study describes FFT use in high-risk, complex patients with only 1 of 15 patients having a postoperative wound complication.