Abdominal wall integrity after open abdomen: long-term results of vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM)

Willms, Arnulf; Schaaf, Sebastian; Schwab, Robert; Richardsen, I.; Bieler, Dan; Wagner, B. P.; Güsgen, Christoph

doi:10.1007/s10029-016-1534-2

Cited by 25 publications

(20 citation statements)

References 24 publications

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“…NPWT is a highly effective method of wound closure with much better results than temporary closure [ 7 , 12 ]. Furthermore, treatment outcomes (wound closure) have been shown to improve dramatically by adding mesh traction [ 6 , 8 , 13 – 16 ].…”

Section: Discussionmentioning

confidence: 99%

Successful abdominal wound closure for treatment of severe peritonitis using negative pressure wound therapy with continuous mesh fascial traction: a case report

et al. 2018

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BackgroundSurgery for severe peritonitis often entails difficult wound closure and may require open abdominal management due to gut edema and/or concern of abdominal compartment syndrome. Negative pressure wound therapy (NPWT) is known to have good outcomes for wound closure after surgery for severe peritonitis. NPWT with continuous mesh fascial traction may result in even better outcomes, especially for fascial closure.Case presentationAn 81-year-old man was hospitalized for abdominal pain. At admission, computed tomography (CT) demonstrated multiple liver metastases and a tumor perforating the sigmoid colon. Acute peritonitis due to perforated sigmoid colon cancer was diagnosed, and emergency peritonitis surgery and Hartmann’s operation were performed. However, at the end of the operation, the surgical abdominal wound could not be closed due to gut edema and concern of abdominal compartment syndrome. Thus, the abdominal wound was left open and NPWT was performed in the primary operation. In the second and subsequent operations, NPWT with mesh fascial traction was performed. The wound was ultimately closed in the fifth operation, which took place 9 days after the primary operation.ConclusionsTreatment of severe peritonitis requires that gastroenterological surgeons learn some form of open abdominal management. This case suggests that NPWT with fascial mesh traction is a suitable solution. Furthermore, it does not require any special materials, and surgeons will find it easy to perform. In sum, NPWT with fascial mesh traction may be the preferred method of open abdominal management over other techniques currently available.

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Section: Discussionmentioning

confidence: 99%

Successful abdominal wound closure for treatment of severe peritonitis using negative pressure wound therapy with continuous mesh fascial traction: a case report

et al. 2018

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“…The incisional hernia rate ranged from 21% at 21 months follow up to 54% at 63 months of follow up. The incisional hernia repair rate was 42% [15] and 33% [14] in the two large prospective studies, respectively. The study patients reported lower short form health survey (SF-36) scores than the mean reference population, mainly dependent on the prevalence of major co-morbidity [14].…”

Section: Study Characteristics Of Long-term Outcome Studiesmentioning

confidence: 92%

“…In 2007, the first report of a modified technique combining vacuum-assisted wound closure with mesh-mediated fascial traction (VAWCM) for long-term therapy of the open abdomen was published [5]. Since then, several centres have adopted this technique and reported their experiences [6][7][8][9][10][11][12][13][14][15]. The aim of this systematic review was to report the short-term and long-term results for the VAWCM technique.…”

mentioning

confidence: 99%

Vacuum-assisted wound closure and mesh-mediated fascial traction for open abdomen therapy — a systematic review

Acosta¹,

Björck²,

Petersson³

2017

Anaesthesiol Intensive Ther

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Background: The aim of this paper was to review the literature on vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) in open abdomen therapy. It was designed as systematic review of observational studies. Methods: A Pub Med, EMBASE and Cochrane search from 2007/01-2016/07 was performed combining the Medical Subject Headings "vacuum", "mesh-mediated fascial traction", "temporary abdominal closure", "delayed abdominal closure", "open abdomen", "abdominal compartment syndrome", "negative pressure wound therapy" or "vacuum assisted wound closure". Results: Eleven original studies were found including patients numbering from 7 to 111. Six studies were prospective and five were retrospective. Nine studies were on mixed surgical (n = 9), vascular (n = 6) and trauma (n = 6) patients, while two were exclusively on vascular patients. The primary fascial closure rate per protocol varied from 80-100%. The time to closure of the open abdomen varied between 9-32 days. The entero-atmospheric fistula rate varied from 0-10.0%. The in-hospital survival rate varied from 57-100%. In the largest prospective study, the incisional hernia rate among survivors at 63 months of median follow-up was 54% (27/50), and 16 (33%) repairs out of 48 incisional hernias were performed throughout the study period. The study patients reported lower short form health survey (SF-36) scores than the mean reference population, mainly dependent on the prevalence of major co-morbidities. There was no difference in SF-36 scores or a modified ventral hernia pain questionnaire (VHPQ) at 5 years of follow up between those with versus those without incisional hernias. Conclusions: A high primary fascial closure rate can be achieved with the vacuum-assisted wound closure and meshmediated fascial traction technique in elderly, mainly non-trauma patients, in need of prolonged open abdomen therapy.

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“…Bauchwandhernien sind die häufigste Langzeitkomplikation nach OAT: Als "geplante Hernie" sind sie natürliche Folge der Unmöglichkeit des Faszienverschlusses nach der abdominalen Katastrophe und als "Narbenhernie nach sekundärem Faszienverschluss" eine Folge der Strukturschwächung der Bauchwand. Die Hernieninzidenz nach OAT liegt neueren Arbeiten zufolge bei 35-66 % nach 4 Jahren [22]. Narbenhernien sind mit einer Reduktion der Funktionalität der Bauchdecke, Schmerzen, Inkarzerationsrisiko und der Notwendigkeit von ggf.…”

Section: Secondunclassified

Offene Abdominalbehandlung – Open Abdomen Treatment

Willms¹,

Schwab²,

Schaaf³

et al. 2020

Allgemein- und Viszeralchirurgie up2date

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Abdominal wall integrity after open abdomen: long-term results of vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM)

Cited by 25 publications

References 24 publications

Successful abdominal wound closure for treatment of severe peritonitis using negative pressure wound therapy with continuous mesh fascial traction: a case report

Successful abdominal wound closure for treatment of severe peritonitis using negative pressure wound therapy with continuous mesh fascial traction: a case report

Vacuum-assisted wound closure and mesh-mediated fascial traction for open abdomen therapy — a systematic review

Offene Abdominalbehandlung – Open Abdomen Treatment

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