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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)
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author
organization
publishing date
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
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
2007-12-14 08:36:46
date last changed
2017-11-12 03:57:07
@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},
  volume       = {31},
  year         = {2007},
}