open access

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
·
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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About this article
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

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

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