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Wound dehiscence: outcome comparison for sutured and mesh reconstructed patients

Petersson, P.; Montgomery, Agneta LU and Petersson, Ulf LU (2014) In Hernia 18(5). p.681-689
Abstract
Treatment guidelines for abdominal wound dehiscence (WD) are lacking. The primary aim of the study was to compare suture to mesh repair in WD patients concerning incisional hernia incidence. Secondary aims were to compare recurrent WD, morbidity, mortality and long-term abdominal wall complaints. A retrospective chart review of 46 consecutive patients operated for WD between January 2010 and August 2012 was conducted. Physical examination and a questionnaire enquiry were performed in January 2013. Six patients were treated by vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) before definitive closure. Three patients died early resulting in 23 patients closed by suture and 20 by mesh repair. Five sutured, but no mesh... (More)
Treatment guidelines for abdominal wound dehiscence (WD) are lacking. The primary aim of the study was to compare suture to mesh repair in WD patients concerning incisional hernia incidence. Secondary aims were to compare recurrent WD, morbidity, mortality and long-term abdominal wall complaints. A retrospective chart review of 46 consecutive patients operated for WD between January 2010 and August 2012 was conducted. Physical examination and a questionnaire enquiry were performed in January 2013. Six patients were treated by vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) before definitive closure. Three patients died early resulting in 23 patients closed by suture and 20 by mesh repair. Five sutured, but no mesh repair patients had recurrent WD (p = 0.051) with a mortality of 60 %. Finally, 18 sutured and 21 mesh repair patients were eligible for follow-up. The incidence of incisional hernia was higher for the sutured patients (53 vs. 5 %, p = 0.002), while mesh repair patients had a higher short-term morbidity rate (76 vs. 28 %, p = 0.004). Abdominal wall complaints were rare in both groups. Suture of WD was afflicted with a high incidence of recurrent WD and incisional hernia formation. Mesh repair overcomes these problems at the cost of more wound complications. VAWCM seems to be an alternative for treating contaminated patients until definitive closure is possible. Long-term abdominal wall complaints are uncommon after WD treatment. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Abdominal wound dehiscence, Burst abdomen, Vacuum-assisted wound closure, and mesh-mediated fascial traction, Mesh, Suture, Incisional hernia
in
Hernia
volume
18
issue
5
pages
681 - 689
publisher
Springer
external identifiers
  • wos:000342497000010
  • scopus:84919425516
ISSN
1248-9204
DOI
10.1007/s10029-014-1268-y
language
English
LU publication?
yes
id
e371806e-30cc-47b5-ae68-bf5980f69c1f (old id 4803439)
date added to LUP
2014-12-01 07:33:52
date last changed
2017-06-18 03:17:21
@article{e371806e-30cc-47b5-ae68-bf5980f69c1f,
  abstract     = {Treatment guidelines for abdominal wound dehiscence (WD) are lacking. The primary aim of the study was to compare suture to mesh repair in WD patients concerning incisional hernia incidence. Secondary aims were to compare recurrent WD, morbidity, mortality and long-term abdominal wall complaints. A retrospective chart review of 46 consecutive patients operated for WD between January 2010 and August 2012 was conducted. Physical examination and a questionnaire enquiry were performed in January 2013. Six patients were treated by vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) before definitive closure. Three patients died early resulting in 23 patients closed by suture and 20 by mesh repair. Five sutured, but no mesh repair patients had recurrent WD (p = 0.051) with a mortality of 60 %. Finally, 18 sutured and 21 mesh repair patients were eligible for follow-up. The incidence of incisional hernia was higher for the sutured patients (53 vs. 5 %, p = 0.002), while mesh repair patients had a higher short-term morbidity rate (76 vs. 28 %, p = 0.004). Abdominal wall complaints were rare in both groups. Suture of WD was afflicted with a high incidence of recurrent WD and incisional hernia formation. Mesh repair overcomes these problems at the cost of more wound complications. VAWCM seems to be an alternative for treating contaminated patients until definitive closure is possible. Long-term abdominal wall complaints are uncommon after WD treatment.},
  author       = {Petersson, P. and Montgomery, Agneta and Petersson, Ulf},
  issn         = {1248-9204},
  keyword      = {Abdominal wound dehiscence,Burst abdomen,Vacuum-assisted wound closure,and mesh-mediated fascial traction,Mesh,Suture,Incisional hernia},
  language     = {eng},
  number       = {5},
  pages        = {681--689},
  publisher    = {Springer},
  series       = {Hernia},
  title        = {Wound dehiscence: outcome comparison for sutured and mesh reconstructed patients},
  url          = {http://dx.doi.org/10.1007/s10029-014-1268-y},
  volume       = {18},
  year         = {2014},
}