Abstract | 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: 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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Authors | Stefan Acosta, Martin Björck, Ulf Petersson |
Journal | Anaesthesiology intensive therapy
(Anaesthesiol Intensive Ther)
Vol. 49
Issue 2
Pg. 139-145
( 2017)
ISSN: 1731-2531 [Electronic] Poland |
PMID | 28502075
(Publication Type: Journal Article, Review, Systematic Review)
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Topics |
- Abdomen
(surgery)
- Abdominal Wound Closure Techniques
(instrumentation)
- Aged
- Humans
- Surgical Mesh
- Time Factors
- Traction
- Vacuum
- Wound Healing
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