One-Year Follow-up After Open Abdomen Therapy With Vacuum-Assisted Wound Closure and Mesh-Mediated Fascial Traction.
Bjarnason, Thordur LU ; Montgomery, Agneta LU ; Ekberg, Olle LU ; Acosta, Stefan LU
; Svensson, Matilda
LU
; Wanhainen, A
; Björck, Matts
LU
and Petersson, Ulf
LU
(2013)
In World Journal of Surgery
37(9).
p.2031-2038
- Abstract
- BACKGROUND: Open abdomen (OA) therapy frequently results in a giant planned ventral hernia. Vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) enables delayed primary fascial closure in most patients, even after prolonged OA treatment. Our aim was to study the incidence of hernia and abdominal wall discomfort 1 year after abdominal closure. METHODS: A prospective multicenter cohort study of 111 patients undergoing OA/VAWCM was performed during 2006-2009. Surviving patients underwent clinical examination, computed tomography (CT), and chart review at 1 year. Incisional and parastomal hernias and abdominal wall symptoms were noted. RESULTS: The median age for the 70 surviving patients was 68 years, 77 % of whom were... (More)
- BACKGROUND: Open abdomen (OA) therapy frequently results in a giant planned ventral hernia. Vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) enables delayed primary fascial closure in most patients, even after prolonged OA treatment. Our aim was to study the incidence of hernia and abdominal wall discomfort 1 year after abdominal closure. METHODS: A prospective multicenter cohort study of 111 patients undergoing OA/VAWCM was performed during 2006-2009. Surviving patients underwent clinical examination, computed tomography (CT), and chart review at 1 year. Incisional and parastomal hernias and abdominal wall symptoms were noted. RESULTS: The median age for the 70 surviving patients was 68 years, 77 % of whom were male. Indications for OA were visceral pathology (n = 40), vascular pathology (n = 22), or trauma (n = 8). Median length of OA therapy was 14 days. Among 64 survivors who had delayed primary fascial closure, 23 (36 %) had a clinically detectable hernia and another 19 (30 %) had hernias that were detected on CT (n = 18) or at laparotomy (n = 1). Symptomatic hernias were found in 14 (22 %), 7 of them underwent repair. The median hernia widths in symptomatic and asymptomatic patients were 7.3 and 4.8 cm, respectively (p = 0.031) with median areas of 81.0 and 42.9 cm(2), respectively (p = 0.025). Of 31 patients with a stoma, 18 (58 %) had a parastomal hernia. Parastomal hernia (odds ratio 8.9; 95 % confidence interval 1.2-68.8) was the only independent factor associated with an incisional hernia. CONCLUSIONS: Incisional hernia incidence 1 year after OA therapy with VAWCM was high. Most hernias were small and asymptomatic, unlike the giant planned ventral hernias of the past. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/3804190
- author
- Bjarnason, Thordur
LU
; Montgomery, Agneta
LU
; Ekberg, Olle
LU
; Acosta, Stefan
LU
; Svensson, Matilda
LU
; Wanhainen, A
; Björck, Matts
LU
and Petersson, Ulf
LU
- organization
- publishing date
- 2013
- type
- Contribution to journal
- publication status
- published
- subject
- in
- World Journal of Surgery
- volume
- 37
- issue
- 9
- pages
- 2031 - 2038
- publisher
- Springer
- external identifiers
-
- wos:000323369400003
- pmid:23703638
- scopus:84882579535
- pmid:23703638
- ISSN
- 1432-2323
- DOI
- 10.1007/s00268-013-2082-x
- language
- English
- LU publication?
- yes
- id
- c72a36d5-1d0a-457d-ae2e-e3d42f3c4d46 (old id 3804190)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/23703638?dopt=Abstract
- date added to LUP
- 2016-04-01 10:57:14
- date last changed
- 2022-05-06 02:56:26
@article{c72a36d5-1d0a-457d-ae2e-e3d42f3c4d46,
abstract = {{BACKGROUND: Open abdomen (OA) therapy frequently results in a giant planned ventral hernia. Vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) enables delayed primary fascial closure in most patients, even after prolonged OA treatment. Our aim was to study the incidence of hernia and abdominal wall discomfort 1 year after abdominal closure. METHODS: A prospective multicenter cohort study of 111 patients undergoing OA/VAWCM was performed during 2006-2009. Surviving patients underwent clinical examination, computed tomography (CT), and chart review at 1 year. Incisional and parastomal hernias and abdominal wall symptoms were noted. RESULTS: The median age for the 70 surviving patients was 68 years, 77 % of whom were male. Indications for OA were visceral pathology (n = 40), vascular pathology (n = 22), or trauma (n = 8). Median length of OA therapy was 14 days. Among 64 survivors who had delayed primary fascial closure, 23 (36 %) had a clinically detectable hernia and another 19 (30 %) had hernias that were detected on CT (n = 18) or at laparotomy (n = 1). Symptomatic hernias were found in 14 (22 %), 7 of them underwent repair. The median hernia widths in symptomatic and asymptomatic patients were 7.3 and 4.8 cm, respectively (p = 0.031) with median areas of 81.0 and 42.9 cm(2), respectively (p = 0.025). Of 31 patients with a stoma, 18 (58 %) had a parastomal hernia. Parastomal hernia (odds ratio 8.9; 95 % confidence interval 1.2-68.8) was the only independent factor associated with an incisional hernia. CONCLUSIONS: Incisional hernia incidence 1 year after OA therapy with VAWCM was high. Most hernias were small and asymptomatic, unlike the giant planned ventral hernias of the past.}},
author = {{Bjarnason, Thordur and Montgomery, Agneta and Ekberg, Olle and Acosta, Stefan and Svensson, Matilda and Wanhainen, A and Björck, Matts and Petersson, Ulf}},
issn = {{1432-2323}},
language = {{eng}},
number = {{9}},
pages = {{2031--2038}},
publisher = {{Springer}},
series = {{World Journal of Surgery}},
title = {{One-Year Follow-up After Open Abdomen Therapy With Vacuum-Assisted Wound Closure and Mesh-Mediated Fascial Traction.}},
url = {{http://dx.doi.org/10.1007/s00268-013-2082-x}},
doi = {{10.1007/s00268-013-2082-x}},
volume = {{37}},
year = {{2013}},
}