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Vol 49, No 2 (2017)
Review articles
Published online: 2017-05-12
Submitted: 2016-12-05
Accepted: 2017-05-01
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Vacuum-assisted wound closure and mesh-mediated fascial traction for open abdomen therapy — a systematic review

Stefan Acosta, Martin Björck, Ulf Petersson
DOI: 10.5603/AIT.a2017.0023
·
Pubmed: 28502075
·
Anaesthesiol Intensive Ther 2017;49(2):139-145.

open access

Vol 49, No 2 (2017)
Review articles
Published online: 2017-05-12
Submitted: 2016-12-05
Accepted: 2017-05-01

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: 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.

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: 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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Keywords

vacuum; mesh-mediated fascial traction; temporary abdominal closure; open abdomen; negative pressure wound therapy

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Title

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

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 49, No 2 (2017)

Pages

139-145

Published online

2017-05-12

DOI

10.5603/AIT.a2017.0023

Pubmed

28502075

Bibliographic record

Anaesthesiol Intensive Ther 2017;49(2):139-145.

Keywords

vacuum
mesh-mediated fascial traction
temporary abdominal closure
open abdomen
negative pressure wound therapy

Authors

Stefan Acosta
Martin Björck
Ulf Petersson

References (39)
  1. Cheatham ML, Safcsak K. Is the evolving management of intra-abdominal hypertension and abdominal compartment syndrome improving survival? Crit Care Med. 2010; 38(2): 402–407.
  2. Atema JJ, Gans SL, Boermeester MA. Systematic review and meta-analysis of the open abdomen and temporary abdominal closure techniques in non-trauma patients. World J Surg. 2015; 39(4): 912–925.
  3. Cirocchi R, Birindelli A, Biffl WL, et al. What is the effectiveness of the negative pressure wound therapy (NPWT) in patients treated with open abdomen technique? A systematic review and meta-analysis. J Trauma Acute Care Surg. 2016; 81(3): 575–584.
  4. Wondberg D, Larusson HJ, Metzger U, et al. Treatment of the open abdomen with the commercially available vacuum-assisted closure system in patients with abdominal sepsis: low primary closure rate. World J Surg. 2008; 32(12): 2724–2729.
  5. Petersson U, Acosta S, Björck M. Vacuum-assisted wound closure and mesh-mediated fascial traction--a novel technique for late closure of the open abdomen. World J Surg. 2007; 31(11): 2133–2137.
  6. Seternes A, Myhre HO, Dahl T. Early results after treatment of open abdomen after aortic surgery with mesh traction and vacuum-assisted wound closure. Eur J Vasc Endovasc Surg. 2010; 40(1): 60–64.
  7. Acosta S, Bjarnason T, Petersson U, et al. Multicentre prospective study of fascial closure rate after open abdomen with vacuum and mesh-mediated fascial traction. Br J Surg. 2011; 98(5): 735–743.
  8. Rasilainen SK, Mentula PJ, Leppäniemi AK. Vacuum and mesh-mediated fascial traction for primary closure of the open abdomen in critically ill surgical patients. Br J Surg. 2012; 99(12): 1725–1732.
  9. Bjørsum-Meyer T, Skarbye M, Jensen KH. Vacuum with mesh is a feasible temporary closure device after fascial dehiscence. Dan Med J. 2013; 60(11): A4719.
  10. Sörelius K, Wanhainen A, Acosta S, et al. Open abdomen treatment after aortic aneurysm repair with vacuum-assisted wound closure and mesh-mediated fascial traction. Eur J Vasc Endovasc Surg. 2013; 45(6): 588–594.
  11. Willms A, Schaaf S, Schwab R, et al. Management of the open abdomen using vacuum-assisted wound closure and mesh-mediated fascial traction. Langenbecks Arch Surg. 2015; 400(1): 91–99.
  12. Seternes A, Rekstad LC, Mo S, et al. Open abdomen treated with negative pressure wound therapy: indications, management and survival. World J Surg. 2017; 41(1): 152–161.
  13. Kääriäinen M, Kuuskeri M, Helminen M, et al. Greater Success of Primary Fascial Closure of the Open Abdomen: A Retrospective Study Analyzing Applied Surgical Techniques, Success of Fascial Closure, and Variables Affecting the Results. Scand J Surg. 2016 [Epub ahead of print].
  14. Petersson U, Bjarnason T, Björck M, et al. Quality of life and hernia development 5 years after open abdomen treatment with vacuum-assisted wound closure and mesh-mediated fascial traction. Hernia. 2016; 20(5): 755–764.
  15. Willms A, Schaaf S, Schwab R, et al. Abdominal wall integrity after open abdomen: long-term results of vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM). Hernia. 2016; 20(6): 849–858.
  16. Mukhi AN, Minor S. Management of the open abdomen using combination therapy with ABRA and ABThera systems. Can J Surg. 2014; 57(5): 314–319.
  17. Kafka-Ritsch R, Zitt M, Schorn N, et al. Open abdomen treatment with dynamic sutures and topical negative pressure resulting in a high primary fascia closure rate. World J Surg. 2012; 36(8): 1765–1771.
  18. Cothren CC, Moore EE, Johnson JL, et al. One hundred percent fascial approximation with sequential abdominal closure of the open abdomen. Am J Surg. 2006; 192(2): 238–242.
  19. Fortelny RH, Hofmann A, Gruber-Blum S, et al. Delayed closure of open abdomen in septic patients is facilitated by combined negative pressure wound therapy and dynamic fascial suture. Surg Endosc. 2014; 28(3): 735–740.
  20. Brandl A, Laimer E, Perathoner A, et al. Incisional hernia rate after open abdomen treatment with negative pressure and delayed primary fascia closure. Hernia. 2014; 18(1): 105–111.
  21. Hougaard HT, Ellebaek M, Holst UT, et al. The open abdomen: temporary closure with a modified negative pressure therapy technique. Int Wound J. 2014; 11 Suppl 1: 13–16.
  22. Kleif J, Fabricius R, Bertelsen CA, et al. Promising results after vacuum-assisted wound closure and mesh-mediated fascial traction. Dan Med J. 2012; 59(9): A4495.
  23. Beltzer C, Eisenächer A, Badendieck S, et al. Retrospective analysis of a VACM (vacuum-assisted closure and mesh-mediated fascial traction) treatment manual for temporary abdominal wall closure - results of 58 consecutive patients. GMS Interdiscip Plast Reconstr Surg DGPW. 2016; 5: Doc19.
  24. Moher D, Liberati A, Tetzlaff J, et al. PRISMA Group, PRISMA Group, PRISMA Group, PRISMA Group, PRISMA Group, PRISMA Group, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. Open Med. 2009; 3(3): e123–e130.
  25. Muysoms FE, Antoniou SA, Bury K, et al. European Hernia Society. European Hernia Society guidelines on the closure of abdominal wall incisions. Hernia. 2015; 19(1): 1–24.
  26. Bjarnason T, Montgomery A, Acosta S, et al. Evaluation of the open abdomen classification system: a validity and reliability analysis. World J Surg. 2014; 38(12): 3112–3124.
  27. Björck M, Bruhin A, Cheatham M, et al. Classification--important step to improve management of patients with an open abdomen. World J Surg. 2009; 33(6): 1154–1157.
  28. Kirkpatrick AW, Roberts DJ, De Waele J, et al. Pediatric Guidelines Sub-Committee for the World Society of the Abdominal Compartment Syndrome. Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome. Intensive Care Med. 2013; 39(7): 1190–1206.
  29. Björck M, Kirkpatrick AW, Cheatham M, et al. Amended Classification of the Open Abdomen. Scand J Surg. 2016; 105(1): 5–10.
  30. Delgado A, Sammons A. In vitro pressure manifolding distribution evaluation of ABThera(™) Active Abdominal Therapy System, V.A.C.(®) Abdominal Dressing System, and Barker's vacuum packing technique conducted under dynamic conditions. SAGE Open Med. 2016; 4: 2050312115624988.
  31. Cheatham ML, Demetriades D, Fabian TC, et al. Prospective study examining clinical outcomes associated with a negative pressure wound therapy system and Barker's vacuum packing technique. World J Surg. 2013; 37(9): 2018–2030.
  32. Kirkpatrick AW, Roberts DJ, Faris PD, et al. Active Negative Pressure Peritoneal Therapy After Abbreviated Laparotomy: The Intraperitoneal Vacuum Randomized Controlled Trial. Ann Surg. 2015; 262(1): 38–46.
  33. Barker DE, Kaufman HJ, Smith LA, et al. Vacuum pack technique of temporary abdominal closure: a 7-year experience with 112 patients. J Trauma. 2000; 48(2): 201–6; discussion 206.
  34. Frazee RC, Abernathy SW, Jupiter DC, et al. Are commercial negative pressure systems worth the cost in open abdomen management? J Am Coll Surg. 2013; 216(4): 730–3; discussion 733.
  35. Rasilainen SK, Mentula PJ, Leppäniemi AK. Components separation technique is feasible for assisting delayed primary fascial closure of open abdomen. Scand J Surg. 2016; 105(1): 17–21.
  36. Hollinsky C, Sandberg S, Kocijan R. Preliminary results with the reinforced tension line: a new technique for patients with ventral abdominal wall hernias. Am J Surg. 2007; 194(2): 234–239.
  37. Agarwal A, Hossain Z, Agarwal A, et al. Reinforced tension line suture closure after midline laparotomy in emergency surgery. Trop Doct. 2011; 41(4): 193–196.
  38. Bjarnason T, Montgomery A, Ekberg O, et al. One-year follow-up after open abdomen therapy with vacuum-assisted wound closure and mesh-mediated fascial traction. World J Surg. 2013; 37(9): 2031–2038.
  39. Muysoms FE, Dietz UA. Prophylactic meshes in the abdominal wall. Chirurg. 2017; 88(Suppl 1): 34–41.

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