Vacuum-assisted wound closure and mesh-mediated fascial traction - A novel technique for late closure of the open abdomen
Petersson, Ulf LU ; Acosta, Stefan LU
and Bjoerck, Martin
(2007)
In World Journal of Surgery
31(11).
p.2133-2137
- Abstract
- Background Open abdomen (OA) treatment often results in difficulties in closing the abdomen. Highest closure rates are seen with the vacuum-assisted wound closure (VAWC) technique. However, we have experienced occasional failures with this technique in cases with severe visceral swelling needing longer treatment periods with open abdomen. Feasibility and short-term outcome of a novel combination of techniques for managing the open abdomen are presented. Methods The VAWC technique was combined with medial traction of the fasciae through a temporary mesh in seven consecutive patients. The VAWC-system was changed and the mesh tightened every 2-3 days. Results Median (range) age in the 7 men was 65 (17-78) years. The diagnoses were ruptured... (More)
- Background Open abdomen (OA) treatment often results in difficulties in closing the abdomen. Highest closure rates are seen with the vacuum-assisted wound closure (VAWC) technique. However, we have experienced occasional failures with this technique in cases with severe visceral swelling needing longer treatment periods with open abdomen. Feasibility and short-term outcome of a novel combination of techniques for managing the open abdomen are presented. Methods The VAWC technique was combined with medial traction of the fasciae through a temporary mesh in seven consecutive patients. The VAWC-system was changed and the mesh tightened every 2-3 days. Results Median (range) age in the 7 men was 65 (17-78) years. The diagnoses were ruptured abdominal aortic aneurysm (AAA) (3), operation for juxtarenal AAA (1), iatrogenic aortic lesion (1), trauma (1) and abdominal abscesses (1). Four patients were decompressed due to abdominal compartment syndrome (ACS) or intra-abdominal hypertension, and 3 could not be closed after laparotomy. Intra-abdominal pressure prior to OA treatment was 24 (17-36) mmHg. Maximal separation of the fasciae was 16 (7 -30) cm. Delayed primary closure was achieved in all patients after 32 (12-52) days with OA. No recurrent ACS was seen. No technique-specific complication was observed. Two small incisional hernias, one intra-abdominal abscess and one wound infection occurred in three patients. Conclusions Delayed primary closure in cases with severe visceral swelling and long periods of OA seems feasible with this technique. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/653311
- author
- Petersson, Ulf
LU
; Acosta, Stefan
LU
and Bjoerck, Martin
- organization
- publishing date
- 2007
- type
- Contribution to journal
- publication status
- published
- subject
- in
- World Journal of Surgery
- volume
- 31
- issue
- 11
- pages
- 2133 - 2137
- publisher
- Springer
- external identifiers
-
- wos:000250243200013
- scopus:35449008128
- ISSN
- 1432-2323
- DOI
- 10.1007/s00268-007-9222-0
- language
- English
- LU publication?
- yes
- additional info
- The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Emergency medicine/Medicine/Surgery (013240200), Surgery Research Unit (013242220), Unit for Clinical Vascular Disease Research (013242410)
- id
- 20a1a05b-4a87-436e-af33-06ec35a635cf (old id 653311)
- alternative location
- http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17879112&dopt=Abstract
- date added to LUP
- 2016-04-01 16:17:45
- date last changed
- 2022-03-07 04:55:19
@article{20a1a05b-4a87-436e-af33-06ec35a635cf,
abstract = {{Background Open abdomen (OA) treatment often results in difficulties in closing the abdomen. Highest closure rates are seen with the vacuum-assisted wound closure (VAWC) technique. However, we have experienced occasional failures with this technique in cases with severe visceral swelling needing longer treatment periods with open abdomen. Feasibility and short-term outcome of a novel combination of techniques for managing the open abdomen are presented. Methods The VAWC technique was combined with medial traction of the fasciae through a temporary mesh in seven consecutive patients. The VAWC-system was changed and the mesh tightened every 2-3 days. Results Median (range) age in the 7 men was 65 (17-78) years. The diagnoses were ruptured abdominal aortic aneurysm (AAA) (3), operation for juxtarenal AAA (1), iatrogenic aortic lesion (1), trauma (1) and abdominal abscesses (1). Four patients were decompressed due to abdominal compartment syndrome (ACS) or intra-abdominal hypertension, and 3 could not be closed after laparotomy. Intra-abdominal pressure prior to OA treatment was 24 (17-36) mmHg. Maximal separation of the fasciae was 16 (7 -30) cm. Delayed primary closure was achieved in all patients after 32 (12-52) days with OA. No recurrent ACS was seen. No technique-specific complication was observed. Two small incisional hernias, one intra-abdominal abscess and one wound infection occurred in three patients. Conclusions Delayed primary closure in cases with severe visceral swelling and long periods of OA seems feasible with this technique.}},
author = {{Petersson, Ulf and Acosta, Stefan and Bjoerck, Martin}},
issn = {{1432-2323}},
language = {{eng}},
number = {{11}},
pages = {{2133--2137}},
publisher = {{Springer}},
series = {{World Journal of Surgery}},
title = {{Vacuum-assisted wound closure and mesh-mediated fascial traction - A novel technique for late closure of the open abdomen}},
url = {{http://dx.doi.org/10.1007/s00268-007-9222-0}},
doi = {{10.1007/s00268-007-9222-0}},
volume = {{31}},
year = {{2007}},
}