Intensive care and health outcomes of open abdominal treatment: long-term results of vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM)

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

doi:10.1007/s00423-017-1575-8

Cited by 12 publications

(16 citation statements)

References 52 publications

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“…Six of fifteen articles reported on long-term outcomes (see Tables 3, 4). The follow-up time was 17-63 months (3,9,11,12,16,21). IH rate was 21-54% (3,9,11,16,21), and the pooled weighted average was 40.5%.…”

Section: Long-term Resultsmentioning

confidence: 99%

“…Only two articles reported on QoL, and both showed that patients treated with OA had lower SF-36 scores than the population mean (3,12), but the presence of an IH influenced the scores negatively only in one of the studies. In one of the studies (3), the scores were overall lower than the Swedish population mean and correlated with major comorbidity and the presence of a stoma but not with the presence of an IH.…”

Section: Discussionmentioning

confidence: 99%

“…This is an update of the review on VAWCM-treated patients published in 2017 (4). In this review, five additional studies meeting our inclusion criteria have been included (12,14,17,20,21), adding data on both short-and long-term outcomes. Fifteen articles were included in this review displaying great heterogeneity among patients with different pathogeneses, comorbidities, and causes for OA therapy.…”

Section: Discussionmentioning

confidence: 99%

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Dynamic Fascial Closure With Vacuum-Assisted Wound Closure and Mesh-Mediated Fascial Traction (VAWCM) Treatment of the Open Abdomen—An Updated Systematic Review

Petersson

2020

Front. Surg.

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Introduction: Several different temporary abdominal closure techniques are described in the context of open abdomen treatment. Techniques based on dynamic fascial closure combined with negative pressure therapy have gained popularity and seem to result in the highest fascial closure rates without increased complications and are highlighted in recent guidelines and recommendations. One dynamic closure technique is the vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) technique, first described in 2007. The aim of this systematic review was to evaluate the VAWCM technique regarding a number of short-and long-term results. Materials and Methods: A systematic literature search was performed in PubMed, EMBASE, and Cochrane Library databases for articles published between January 1, 2006 and May 8, 2020. The review was independently performed by the two authors according to the PRISMA statements for reporting systematic reviews and meta-analyses. Results were pooled for presentation of weighted means when applicable. Results: A total of 220 articles were screened by title and abstract. Thirty-two articles were assessed for eligibility by full-text review and 15 articles finally remained for review. A total of 600 patients treated with VAWCM were included. The pooled weighted means were as follows: fascial closure, 83.5%; enteroatmospheric fistula, 5.6%; planned ventral hernia, 6.2%; in-hospital survival, 72%; and incisional hernia incidence, 40.5%. Long-term survival ranged between 22 and 72%. Quality of life (SF-36) was reported in two studies showing lower scores than the population mean especially in physical domains. Incisional hernia resulted in lower scores in one but not in the other study. Discussion: The results of 600 VAWCM-treated patients from 15 studies were evaluated in this systematic review. Earlier findings with high fascial closure rates, low Petersson and Petersson VAWCM-An Updated Systematic Review enteroatmospheric fistula, and planned ventral hernia rates as well as high incisional hernia incidences were underlined. Permanent mesh for efficient fascial traction and reinforcement at fascial closure seem to be the next step in evolving an optimal temporary closure technique in open abdomen treatment.

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Section: Long-term Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Dynamic Fascial Closure With Vacuum-Assisted Wound Closure and Mesh-Mediated Fascial Traction (VAWCM) Treatment of the Open Abdomen—An Updated Systematic Review

Petersson

2020

Front. Surg.

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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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“…The open abdomen may help reduce the risk of abdominal compartment syndrome in patients requiring prolonged resuscitation. Various abdominal closure techniques have been described, however, the guiding principle is constant traction on the fascia to facilitate closure [72][73][74][75].…”

Section: Endovascular Revascularization Procedures May Have a Role Wimentioning

confidence: 99%

Acute Mesenteric Ischemia

Bala¹,

Kashuk²

2016

Acute Care Surgery Handbook

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Intensive care and health outcomes of open abdominal treatment: long-term results of vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM)

Cited by 12 publications

References 52 publications

Dynamic Fascial Closure With Vacuum-Assisted Wound Closure and Mesh-Mediated Fascial Traction (VAWCM) Treatment of the Open Abdomen—An Updated Systematic Review

Dynamic Fascial Closure With Vacuum-Assisted Wound Closure and Mesh-Mediated Fascial Traction (VAWCM) Treatment of the Open Abdomen—An Updated Systematic Review

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

Acute Mesenteric Ischemia

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