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Quality of life and hernia development 5 years after open abdomen treatment with vacuum-assisted wound closure and mesh-mediated fascial traction

Petersson, U. LU ; Bjarnason, T. LU ; Björck, M.; Montgomery, A. LU ; Rogmark, P. LU ; Svensson, M.; Sörelius, K. and Acosta, S. LU (2016) In Hernia 20(5). p.755-764
Abstract

Purpose: To report incisional hernia (IH) incidence, abdominal wall (AW) discomfort and quality of life (QoL) 5 years after open abdomen treatment with vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM). Methods: Five-year follow-up of patients included in a prospective study 2006–2009. The protocol included physical examination, patient interview, chart review, questionnaires on abdominal wall and stoma complaints and the SF-36 questionnaire. Results: Fifty-five (12 women, 43 men; median age 70 years) of 111 included patients were alive. Follow-up rate was 91 %. Cumulative IH incidence during the whole study was 62 %. One-third of the IHs was repaired. At 5-year follow-up 59 % of IHs were clinically detectable. AW... (More)

Purpose: To report incisional hernia (IH) incidence, abdominal wall (AW) discomfort and quality of life (QoL) 5 years after open abdomen treatment with vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM). Methods: Five-year follow-up of patients included in a prospective study 2006–2009. The protocol included physical examination, patient interview, chart review, questionnaires on abdominal wall and stoma complaints and the SF-36 questionnaire. Results: Fifty-five (12 women, 43 men; median age 70 years) of 111 included patients were alive. Follow-up rate was 91 %. Cumulative IH incidence during the whole study was 62 %. One-third of the IHs was repaired. At 5-year follow-up 59 % of IHs were clinically detectable. AW symptoms were equivalent in patients with (15/23) and without (11/21) IH (p = 0.541). SF-36 scores were lower than population mean for component scores and all subscales except bodily pain. Patients with major co-morbidity had lower physical component score [31.6 (95 %, CI 25.6–37.4)] compared to those without [48.9 (95 %, CI 46.2–51.4)]. Major co-morbidity was not associated with IH (p = 0.56), AW symptoms (p = 0.54) or stoma (p = 0.10). Patients with IH or other AW symptoms had similar SF-36 results compared to those without, whereas patients with a stoma had >5 point lower mean scores for general health, social function and physical component score compared to those without. Conclusions: VAWCM treatment results in high incidence of IH. However, at five years, there was no detectable difference in abdominal wall complaints and QoL in patients with IH compared to those without. Lower QoL appeared mainly to be associated with the presence of major co-morbidity.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Incisional hernia, Mesh-mediated fascial traction, Open abdomen, Quality of life, SF-36, Vacuum-assisted wound closure
in
Hernia
volume
20
issue
5
pages
10 pages
publisher
Springer
external identifiers
  • Scopus:84975266775
  • WOS:000383514200017
ISSN
1265-4906
DOI
10.1007/s10029-016-1516-4
language
English
LU publication?
yes
id
0434c885-2a5a-4f26-85f9-ab6844744818
date added to LUP
2016-07-08 10:00:37
date last changed
2017-01-09 13:52:36
@article{0434c885-2a5a-4f26-85f9-ab6844744818,
  abstract     = {<p>Purpose: To report incisional hernia (IH) incidence, abdominal wall (AW) discomfort and quality of life (QoL) 5 years after open abdomen treatment with vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM). Methods: Five-year follow-up of patients included in a prospective study 2006–2009. The protocol included physical examination, patient interview, chart review, questionnaires on abdominal wall and stoma complaints and the SF-36 questionnaire. Results: Fifty-five (12 women, 43 men; median age 70 years) of 111 included patients were alive. Follow-up rate was 91 %. Cumulative IH incidence during the whole study was 62 %. One-third of the IHs was repaired. At 5-year follow-up 59 % of IHs were clinically detectable. AW symptoms were equivalent in patients with (15/23) and without (11/21) IH (p = 0.541). SF-36 scores were lower than population mean for component scores and all subscales except bodily pain. Patients with major co-morbidity had lower physical component score [31.6 (95 %, CI 25.6–37.4)] compared to those without [48.9 (95 %, CI 46.2–51.4)]. Major co-morbidity was not associated with IH (p = 0.56), AW symptoms (p = 0.54) or stoma (p = 0.10). Patients with IH or other AW symptoms had similar SF-36 results compared to those without, whereas patients with a stoma had &gt;5 point lower mean scores for general health, social function and physical component score compared to those without. Conclusions: VAWCM treatment results in high incidence of IH. However, at five years, there was no detectable difference in abdominal wall complaints and QoL in patients with IH compared to those without. Lower QoL appeared mainly to be associated with the presence of major co-morbidity.</p>},
  author       = {Petersson, U. and Bjarnason, T. and Björck, M. and Montgomery, A. and Rogmark, P. and Svensson, M. and Sörelius, K. and Acosta, S.},
  issn         = {1265-4906},
  keyword      = {Incisional hernia,Mesh-mediated fascial traction,Open abdomen,Quality of life,SF-36,Vacuum-assisted wound closure},
  language     = {eng},
  number       = {5},
  pages        = {755--764},
  publisher    = {Springer},
  series       = {Hernia},
  title        = {Quality of life and hernia development 5 years after open abdomen treatment with vacuum-assisted wound closure and mesh-mediated fascial traction},
  url          = {http://dx.doi.org/10.1007/s10029-016-1516-4},
  volume       = {20},
  year         = {2016},
}