Contact Us

Faran Bokhari, MD, Trauma Chairman

1900 W. Polk St. Rm 1300
Chicago, IL 60612

In the early 1990’s the concept of damage control surgery revolutionized the world of truama and dramatically changed how trauma surgeons operate. The concept focuses on abreviated initial operations placing more emphasis on the body’s metabolic responses ¬†and less on restoring anatomy to the pre-injury state. These concepts include minimizing time in the operating room, leaving the abdomen open and covered, and early re-warming and resuscitation in the ICU. Although this concept has dramatically improved patient survival, one of the unintended consequences has been the inability to close the open abdomen as the muscles retract leaving the abdomen chronically open. This dilemma has taken surgeons through the gammat in trying various methods of closure, from costly prosthetics to simply skin grafting over the exposed bowel. In 2008, researchers at the Cook County Trauma Unit, undertook an initiative to try to solve this dilemma in their patient population. By thinking outside the box, the trauma surgeons at County re-defined the open abdomen as a result of muscle shortening and contracture and began to apply physical medicine techniques to attempt to lenghten the muscles and to restore them to natural length in order to close the abdomen.

This technique was called Trans Abdominal Wall Traction (TAWT) and it has been virtually 100% successful at solving a worldwide surgical problem.

TAWT combines the physical medicine concepts of constant isometric traction with a surgical technique and device now a system by which virtually any open abdomen, acute and chronic can be closed.

Although TAWT began at Cook County Hospital, it has now taken hold world-wide and is being frequently used by surgeons around the world to close open abdomens and giant ventral hernias.

Below is a video on the TAWT technique.

 

TAWT Removal Final

For information on complex abdominal wall reconstructions and TAWT please contact Dr. Andrew Dennis at (312) 864-2733 or adenines@cookcountytrauma.org.