463:, Algeria, and took his young family to Algeria for an anticipated two-year commitment. After a year political unrest forced the Wittmanns to return to Germany but by then he had seen many diseases in their advanced stages including abdominal infections. The culmination of experiences led Wittmann to begin to develop a means to keep the abdominal wall safely open for serial intra-operative treatment and control of healing processes. Early attempts used a variety of temporary closure devices such as retention sutures, zippers, and slide fasteners. Ultimately he discovered the method of hook and loop fasteners to be optimal for closing the abdomen temporarily. In 1988 he joined the faculty of Robert E. Condon and Charles Aprahamian at the Medical College of Wisconsin and became a full professor of surgery. He developed one of the first US surgical critical care fellowship programs at the Medical College of Wisconsin in 1990 and became its first director. In 2000 Wittmann retired from the medical college but continued his work on the staged abdominal repair and the hook and loop fastener temporary fascia prosthesis. He remained active providing advice to surgeons worldwide using his website www.openabdomen.org and continued to lecture about the fundamental benefits of the planned open abdomen.
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measured in tissues were then compared to concentrations required to kill bacteria to serve as the foundation of anti-infective therapies. Based on these studies
Wittmann habilitated for professor of surgery at the University of Hamburg defending his thesis about the concentration dynamics of antimicrobials intra-abdominal infections. In 1972 Wittmann had the opportunity to work in
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22:
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Concerning antimicrobial therapy of surgical infection, he started measuring antibiotic concentrations in tissue fluid representative for the site of infection by analyzing body fluids and bone chips and that would have been disposed of in the course of surgical procedures. Antibiotic concentrations
666:
Wittmann DH. Antibiotic concentration in tissue fluid during the vulnerable period as rational basis for prophylaxis of post-operative infections: Focus on infections after operations of the colon biliary tree and bone. In J Ishigami (Ed), Recent
Advances in Chemotherapy, University of Tokyo Press,
723:
Wittmann DH, Aprahamian C, Bergstein JM, Bansal N, Wallace JR, Wittmann MM: Staged
Abdominal Repair Compares Favorably to Conventional Operative Therapy for Intra-abdominal Infections when Adjusting For prognostic Factors with a Logistic Model. Theoretical Surg (Now European J Surg) 25:273-284,
384:
and staged abdominal repair STAR. Besides introducing the concept of calculated antimicrobial therapy
Wittmann conceptualized the operative strategy of Staged Abdominal Repair (STAR) or the planned open abdomen to reverse the detrimental effects of the abdominal compartment syndrome and to treat
727:
Wittmann DH, Gores JA, Rangabashyam N, Sayek, I. Laparostomy, Open
Abdomen, Etappenlavage, Planned Relaparotomy and Staged Abdominal Repair: Too Many Names for a New Operative Method. In Ruedi (Ed), State of the Art of Surgery, 1993/1994, International Society of Surgery, Reinach, Switzerland.
745:
Wittmann DH: Newer methods of operative therapy for peritonitis: Open abdomen, planned relaparotomy or staged abdominal repair: Is there a difference? (in
Japanese including Commentary by Japanese author) Churchill Communications Osaka: Japan. Clinical Infection & Chemother 1:40-41,
607:
Wittmann DH, Schassan H-H, Freitag V. Correlation of pharmacokinetic-bacteriological findings with clinical results of antimicrobial therapy for peritonitis. In B Wiedemann (Ed): Die
Resistenz gegenüber Beta-lactam-Antibiotika. Bad Honnef, Germany, pp. 242–249,
488:
1982: First-time investigation of the relevance of protein binding in humans by synchronous application and measurements of two penicillins with the same half-life but different degrees of protein binding. Measurements were performed in serum and in peritoneal
385:
imminent intra abdominal complications before they progress to life-threatening conditions. He is the inventor of a fascia prosthesis for temporary abdominal closure, the
Artificial Bur Fascia Prosthesis (generic) or Wittmann Patch and Star Patch (trade names).
697:
Wittmann DH, Aprahamian C, Bergstein JM. Etappenlavage: Advanced diffuse peritonitis managed by planned multiple laparotomies utilizing zippers, slide fastener, and Velcro analogue for temporary abdominal closure. World J Surg 14:218-226,
407:
from the
University of Hamburg. Two years later Wittmann defended a Ph.D. thesis in Neurophysiology/Toxicology at the University of DĂĽsseldorf on the affinity of carbon monoxide to hemoglobin of various laboratory animals and men.
802:
Wittmann, DH. Letter to the Editor J Trauma. 2011;70: 273-277) Sew it Up! A Western Trauma
Association Multi-Institutional Study of Enteric Injury Management in the Post injury Open Abdomen by WTA Study Group.J Trauma. 2012;71:
789:
Luchette, FA, Borzotta, AP, Croce, MA, O’Neil, P, Wittmann, DH, Mullins, D and Palumbo, F: EAST Guideline: Practice Management Guidelines for Prophylactic Antibiotic Use in Penetrating Abdominal Trauma. J Trauma 48;508-516,
741:
Wittmann DH, Schein M, Seoane D, Aprahamian C, Komorowski RA, Georgakas K, Quebbeman EJ, Wallace JR, Condon RE: Pyoderma Fistulans Sinifica (Fox Den Disease): A distinctive soft-tissue infection. 1995 Clin Infect Dis
379:
Milwaukee, USA . In addition to his clinical work, research, publications and teaching and lecturing worldwide, he is mostly known for his work relating to intra-abdominal infections, abdominal compartment syndrome
535:
414 Staged abdominal repair: Development and current practice of an advanced operative technique for diffuse suppurative peritonitis by Dietmar H. Wittmann. European Surgery 32(4):171-178 (DOI: 10.1007/BF02949258)
478:
1979: Invention of the "Kuh von Altona, a suctioning device to collect otherwise not used body fluids from patients for pharmacokinetic investigations and to collect pro-inflammatory and inflammatory mediators and
713:
Wittmann DH, Aprahamian C, Bergstein JM, Edmiston CE, Frantzides CT, Quebbeman EJ, Condon RE: A burr-like device to facilitate temporary abdominal closure in planned multiple laparotomies. Eur J Surg 159:75-79,
531:
212 A burr-like device to facilitate temporary abdominal closure in planned multiple laparotomies. by Dietmar H. Wittmann, Charles Aprahamian, Jack M. Bergstein, Charles E. Edmiston. Eur J Surg 159: 75-79, 1993
611:
Wittmann DH, Schassan H-H. Influence of protein binding on tissue penetration of Isooxaloyl-and Alcylureido-Penicillins. Current Chemother Immunotherapy, American Society for Microbiology Washington DC, 1981,
694:
Nyström PO, Bax R, Dellinger EP, Dominioni L, Knaus WA, Meakins JL, Ohmann Ch, Solomkin JS, Wacha H, Wittmann DH. A proposed standard for trials on intra-abdominal infection. World J Surg 14:148-156, 1990.
603:
Wittmann DH, Kirschner H. Educational recommendations regarding the intern year based on the practical experience in the two surgical departments at Altona General Hospital. Hamburger Ă„rzteblatt 3:181-184,
734:
Holzheimer RG, Schein M, Wittmann DH: (335b) Inflammatory response in peritoneal exudate and plasma of patients undergoing planned relaparotomy for severe secondary peritonitis. Arch Surg 130; 1314-1320,
767:
Slakey DP, Johnson CP, Cziperle DJ, Roza AM, Wittmann, DH, Gray DWR, Roake JA, Britton, J, Morris PJ, Adams MB: Management of Severe Pancreatitis in Renal Transplant Recipients. Ann. Surg 225, 217-222,
738:
Schein M, Wittmann DH, Aprahamian C, Condon RE: The abdominal compartment syndrome: The physiological and clinical consequences of elevated intra-abdominal pressure. J Am Coll Surg 180:744-753, 1995.
633:
Wittmann DH, Berghoff D, Reynders-Frederix V, Schassan H-H. Significance of hydroxyl apatite with regard to determination of antimicrobial bone concentrations. Arzneim Forsch/Drug Res 33:423-426, 1983.
423:(surgeon for soft tissue, visceral and orthopedic trauma).In 1988, after organizing an International Congress in Hamburg, Germany, with the sole topic of intra-abdominal infection and founding the
475:
1977: First-time investigation of antibiotic concentrations in body fluids of patients as a basis to guide antimicrobial therapy and monitor penetration of antibiotics to the site of infection.
877:
673:
Wittmann DH, Kotthaus E. Further methodological improvements in antibiotic bone concentration measurements: penetration of ofloxacin into bone and cartilage. Infection 14:S270-273, 1986.
615:
Wittmann DH, Schassan H-H. Bone concentrations of six new beta-lactam-antibiotics. Current Chemother Immunother, American Society for Microbiology Washington DC, 1981, pp. 628–629.
507:
1987: The Artificial Bur Fascia Prosthesis, a temporary abdominal closure device that facilitates planned relaparotomies or Staged Abdominal Repairs (STAR or Stage Injury Repair (STIR).
522:
1995: Dynamic Antibiotic Switching Therapy (DAST), a new form of antibiotic treatment: changing the antibiotic regimen every 24 hours to avoid selection of resistant bacterial strains.
862:
796:
Wittmann, DH. Staged abdominal Repair: Development and Current Practice of an Advanced Operative Technique for Diffuse Suppurative Peritonitis: European Surgery 32; 171-178, 2000.
717:
Page CP, Bohnen JMA, Fletcher JR, McManus AT, Solomkin JS, Wittmann DH: Antimicrobial Prophylaxis for Surgical Wounds: Guidelines for Clinical Care. Arch Surg 128:79-88,1993.
636:
Winker H, Dörtemann J, Wittmann DH. Prophylaxis of infections after elective colon surgery. Result of a prospective controlled double blinded study. Chirurg 54:272-277, 1983.
688:
Wittmann DH. Use and abuse of antibiotics worldwide: summary report from the WHO working group on prophylaxis of postoperative wound infections. Infection 17:46-57, 1989.
731:
Wittmann DH, Schein M, Condon RE: Antibiotic Prophylaxis in Abdominal Wall Hernia Surgery: Never, Always, or Selectively? Problems in General Surgery 12, 47-55, 1995.
485:
1981: First-time differentiation of various bone compartments to identify the bone compartment that is relevant for infection and where antibiotics should concentrate.
588:
Wittmann DH, Eggert A. A new method to obtain high concentrations of gastrin for quantitative analysis of different human gastrin fractions. Chirurg 48:159-160, 1977.
710:
Frantzides CT, Lianos EA, Wittmann D, Greenwood B, Edmiston CE: Prostaglandins and modulation of small bowel myoelectric activity. Am J Physiol 262:G488-497, 1992.
872:
624:
Eggert A, Teichmann W, Wittmann DH. Pathological implication of duodenal diverticula. Surg Gynecol Obstet (now J American College of Surgeons) 154:62-64, 1982.
401:, Germany. He studied Medicine at the medical schools of Hamburg, DĂĽsseldorf, and the University of California San Francisco Medical School. He graduated
618:
Wittmann DH. Suitable preoperative precautions to reduce the risk of post-operative infection following abdominal procedures. Umweltmedizin 3:38-40, 1981.
755:
Schein, M, Wittmann DH, Holzheimer, R, Condon, RE: Hypothesis: Compartmentalization of Cytokines in Intra-abdominal Infection. Surgery 119;694-700, 1996.
639:
Wittmann DH, Kirschner H, Luetkens S. Long term results of elective and urgent highly selective vagotomy. Langenbecks Arch Chir 361:(243)671-672, 1983.
657:
Wittmann DH, Teichmann W, Frommelt L. Importance of pathogenic bacteria with regard to therapy of suppurative peritonitis. Chirurg 56:363-370, 1985.
594:
Wittmann DH, Eckardt K, Randel G. The risk of cancer in papillomatous disease of the breast. Verhandlungen Deutsche Krebs Gesellschaft 2:64-65, 1979.
510:
1991: STAR (Staged Abdominal Repair), a new operative approach for intra-abdominal infections utilizing the hook and loop fastener fascia prosthesis.
359:(born June 16, 1940) is a German academic surgeon specializing in complex abdominal surgery. He was associated with the following medical schools:
793:
Wittmann DH, Iskander GA. The Abdominal Compartment Syndrome: Invited State-of-the-Art Paper. Journal of Intensive Care Medicine, 15; 201-220, 2000.
627:
Wittmann DH, Kellinghusen C, Welter J, Freitag V. Intra-abdominal infections: results of a prospective randomized trial. Act Chir 18:229-353, 1983.
882:
150:
130:
752:
Wittmann MM, Wittmann AM, Wittmann DH; AIDS, Emergency Operations, and Infection Control. Infect Control Hosp Epidemiology 17;532-538, 1996.
600:
Wittmann DH. Chemotherapeutic principles in difficult-to-treat infections in surgery. II. Bone and joint infections. Infection 8:330-333, 1980.
701:
Wittmann DH, Bergstein JM, Frantzides C. Calculated empirical antibiotic treatment of acute surgical infections. Infection 19:S345-350, 1991.
764:
Schein M, Wittmann DH, Wittmann AM, Condon REC. Abdominal contamination, infection and Sepsis; a continuum. Br. J. Surg. 84;269-272, 1997.
761:
Wittmann, DH, Schein, M: Let us shorten antibiotic prophylaxis and therapy in surgery. American Journal of Surgery. 172(6A):26S-32S, 1996.
691:
Wittmann DH, Bergstein JM, Aprahamian C. Etappenlavage for diffuse peritonitis. Beitrag Anästhesie und Intensivmedizin 30:199-221, 1989.
642:
Jeckstadt P, Wittmann DH. A prognostic index for intra-abdominal infections. Fortschr Antimicrob Antineoplast Chemother 2:517-525, 1983.
685:
Wittmann DH, Teichmann W, MĂĽller M. Development and validation of peritonitis indices Altona. Langenbecks Arch Chir 372:834-835, 1987.
648:
Wittmann DH. Bacteriological findings in different forms of peritonitis. Fortschr Antimicrob Antineoplast Chemother 2:423-429, 1983.
582:
Adler E, Wittmann DH. Acute hemorrhage of gastroduodenal ulcer managed without adequate blood transfusions. Zbl Chir 100:598-602, 1975.
513:
1993: STIR (Staged Injury Repair), a new operative approach for severe trauma utilizing the hook and loop fastener fascia prosthesis.
343:
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103:
49:
35:
670:
Teichmann W, Wittmann DH, Andreone PA. Scheduled reoperations (Etappenlavage) for diffuse peritonitis. Arch Surg 121:147-152, 1986.
707:
Condon RE, Wittmann DH: The Use of Antibiotics in General Surgery. Mosby Year Book. Current Problems in Surgery 28:803-949, 1991.
867:
654:
Teichmann W, Eggert A, Wittmann DH, Böcker W. The zipper: new method for temporary abdominal closure. Chirurg 56:173-178, 1985.
645:
Wittmann DH. Development and goals of the Study Group Peritonitis. Fortschr Antimicrob Antineoplast Chemother 2:311-317, 1983.
597:
Wittmann DH. Chemotherapeutic principles in difficult-to-treat infections in surgery. I. Peritonitis. Infection 8:323-329, 1980.
887:
306:
204:
81:
720:
Schein M. Wittmann DH. Antibiotics in abdominal surgery: the less the better European Journal of Surgery. 159(9):451-3, 1993.
857:
679:
Wittmann DH . Infection control and quality assurance in surgery. Krankenhaus-Hygiene und InfektionsverhĂĽtung 8:66-74, 1986.
651:
Wittmann DH. Clinical use and pharmacokinetics of metronidazole. Fortschr Antimicrob Antineoplast Chemother 2:757-782, 1983.
381:
278:
263:
256:
176:
774:
Wittmann, DH. Practice Management Guidelines For Prophylactic Antibiotics In Penetrating Abdominal Trauma East Guidelines
663:
Wittmann DH. Calculated antibiotic therapy of infections following abdominal trauma. Infections in Surgery, 4:S21-23, 1985.
630:
Wittmann DH, Schassan H-H. Penetration of eight beta-lactam antibiotics into peritoneal fluid. Arch Surg 118:205-212, 1983.
758:
Wittmann, DH: (348b) Pharmacokinetic basis for short courses of antimicrobial therapy. Eur J Surg, Suppl 576:19-23; 1996.
676:
Wittmann DH. Prophylaxis of post-operative infections: single dose or multiple dosing? Krankenhausarzt 59:515-534, 1986.
424:
660:
Wittmann DH, Teichmann W. Etappenlavage and treatment of pathogenic bacteria. Langenbecks Arch Chir 366:629-630, 1985.
376:
285:
183:
436:
364:
621:
Wittmann DH, Schassan H-H. Basics for antimicrobial therapy of peritonitis. Langenbecks Arch Chir 358:589-590, 1982.
852:
771:
Wittmann DH. Scope and Limitations of Antimicrobial Therapy of Sepsis. Langenbecks Archive for Surgery. 383; 15-25.
154:
146:
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190:
847:
372:
135:
799:
Nyström P-O, Wittmann D . Patient to surgeon infections - fact or fiction. Br J Surg. 2003 Nov; 90(11):1315-6.
585:
Wittmann DH, Schröder HJ. Diagnostic and therapeutic problems with gallstone ileus. Act Chir 11:247-602, 1976.
274:
172:
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139:
73:
482:
1980: Pharmacodynamics: Antimicrobial concentrations at the site of infection as the foundation of therapy.
842:
783:
Wittmann DH. Operative and Nonoperative Therapy of Intra-abdominal Infections. Infection 26:335-341, 1998.
749:
Wittmann DH, Schein M, Condon RE: Management of Secondary Peritonitis. Annals of Surgery 224;10-18, 1996.
682:
Wittmann DH, MĂĽller M. Patient stratification in intra-abdominal infektion. Chemiotherapia 6S:5-8, 1987.
411:
Following medical school he continued his surgical training in Hamburg, Philadelphia, Annaba, Algeria, (
360:
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41:
837:
786:
Wittmann DH, Antibiotic prophylaxis in biliary surgery. Chirurgische Gastroenterologie, 15:1-8, 1999.
368:
516:
1994: Quality of life after trauma as an outcome criterion to measure the quality of trauma care.
417:) to become Board certified General Surgeon and after an additional two years, a Board certified
806:
Wittmann, DH. History of the Surgical Infections Society – Europe. Surg Infect 10(2013) p 1-11
704:
Wittmann DH, Condon RE. Prophylaxis of postoperative infections. Infection, 19;S337-343, 1991.
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vein blood long before sophisticated analysis methods to measure pg levels were established.
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161:
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1987: Peritonitis Index Altona PIA-II (Scoring system for intra-abdominal infections).
427:, he accepted a position as professor of surgery at the Medical College of Wisconsin.
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1983: Peritonitis Index Altona PIA-I (Scoring system for intra-abdominal infections).
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1983: First-time investigation to measure inflammatory proteins in peritoneal fluid.
76:
or has been extensively edited by the subject or by someone connected to the subject
440:
591:
Wittmann DH, Eggert A. Pathogenesis of gallstone ileus. Chirurg 48:678-680, 1977.
548:
Patent No.8,469,996 Apparatus Temp Fascia Prosthesis-(Wittmann Patch)2013-06-25
472:
1976: Measurement of pre-hepatic gastrin concentrations by antral vein puncture.
397:, Germany, and educated in France and Germany before starting medical school in
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of the University of Hamburg Medical School. His early research was focused on
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Patent No.7,662,169 Methd Temp Fascia Prosthesis (Wittmann Patch)2010-02-16
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from the article and its talk page, especially if potentially
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1987: Foundation of the Surgical Infection Society - Europe.
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Patent No.8,128,655 Apparatus Wittmann-Hypopack-2012-03-06
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Mission Chirurgicale de la République Fédérale d' Allemagne
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Patent No.7,658,749 Method Wittmann Hypopack 2010-02-09
369:
University of California San Francisco Medical School
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84:policy. There may be relevant discussion on the
863:University of California, San Francisco alumni
80:It may need editing to conform to Knowledge's
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50:Learn how and when to remove these messages
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838:1940 births
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467:Inventions
451:levels in
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36:improve it
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389:Biography
136:citations
86:talk page
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445:vagotomy
395:Duisburg
162:libelous
527:Patents
449:gastrin
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