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Vacuum-Assisted wound closure and mesh-mediated fascial traction for open abdomen therapy - a systematic review

Acosta, Stefan LU ; Björck, Martin and Petersson, Ulf LU (2017) In Anaesthesiology Intensive Therapy 49(2). p.139-145
Abstract

Background: The aim of this paper was to review the literature on vacuum-Assisted wound closure and mesh-mediated fascial traction (VAWCM) in open abdomen therapy. It was designed as systematic review of observational studies. Methods: A Pub Med, EMBASE and Cochrane search from 2007/01-2016/07 was performed combining the Medical Subject Headings "vacuum", "mesh-mediated fascial traction", "temporary abdominal closure", "delayed abdominal closure", "open abdomen", "abdominal compartment syndrome", "negative pressure wound therapy" or "vacuum assisted wound closure". Results: Eleven original studies were found including patients numbering from 7 to 111. Six studies were prospective and five were retrospective. Nine studies were on mixed... (More)

Background: The aim of this paper was to review the literature on vacuum-Assisted wound closure and mesh-mediated fascial traction (VAWCM) in open abdomen therapy. It was designed as systematic review of observational studies. Methods: A Pub Med, EMBASE and Cochrane search from 2007/01-2016/07 was performed combining the Medical Subject Headings "vacuum", "mesh-mediated fascial traction", "temporary abdominal closure", "delayed abdominal closure", "open abdomen", "abdominal compartment syndrome", "negative pressure wound therapy" or "vacuum assisted wound closure". Results: Eleven original studies were found including patients numbering from 7 to 111. Six studies were prospective and five were retrospective. Nine studies were on mixed surgical (n = 9), vascular (n = 6) and trauma (n = 6) patients, while two were exclusively on vascular patients. The primary fascial closure rate per protocol varied from 80-100%. The time to closure of the open abdomen varied between 9-32 days. The entero-Atmospheric fistula rate varied from 0-10.0%. The in-hospital survival rate varied from 57-100%. In the largest prospective study, the incisional hernia rate among survivors at 63 months of median follow-up was 54% (27/50), and 16 (33%) repairs out of 48 incisional hernias were performed throughout the study period. The study patients reported lower short form health survey (SF-36) scores than the mean reference population, mainly dependent on the prevalence of major co-morbidities. There was no difference in SF-36 scores or a modified ventral hernia pain questionnaire (VHPQ) at 5 years of follow up between those with versus those without incisional hernias. Conclusions: A high primary fascial closure rate can be achieved with the vacuum-Assisted wound closure and meshmediated fascial traction technique in elderly, mainly non-Trauma patients, in need of prolonged open abdomen therapy.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Mesh-Mediated Fascial Traction, Negative Pressure Wound Therapy, Open Abdomen, Temporary Abdominal Closure, Vacuum
in
Anaesthesiology Intensive Therapy
volume
49
issue
2
pages
7 pages
external identifiers
  • scopus:85021234106
  • wos:000404441500009
ISSN
1642-5758
DOI
10.5603/AIT.a2017.0023
language
English
LU publication?
yes
id
e253c86c-8fad-471e-b216-902f7bd24b35
date added to LUP
2017-08-10 12:12:28
date last changed
2017-09-18 11:41:18
@article{e253c86c-8fad-471e-b216-902f7bd24b35,
  abstract     = {<p>Background: The aim of this paper was to review the literature on vacuum-Assisted wound closure and mesh-mediated fascial traction (VAWCM) in open abdomen therapy. It was designed as systematic review of observational studies. Methods: A Pub Med, EMBASE and Cochrane search from 2007/01-2016/07 was performed combining the Medical Subject Headings "vacuum", "mesh-mediated fascial traction", "temporary abdominal closure", "delayed abdominal closure", "open abdomen", "abdominal compartment syndrome", "negative pressure wound therapy" or "vacuum assisted wound closure". Results: Eleven original studies were found including patients numbering from 7 to 111. Six studies were prospective and five were retrospective. Nine studies were on mixed surgical (n = 9), vascular (n = 6) and trauma (n = 6) patients, while two were exclusively on vascular patients. The primary fascial closure rate per protocol varied from 80-100%. The time to closure of the open abdomen varied between 9-32 days. The entero-Atmospheric fistula rate varied from 0-10.0%. The in-hospital survival rate varied from 57-100%. In the largest prospective study, the incisional hernia rate among survivors at 63 months of median follow-up was 54% (27/50), and 16 (33%) repairs out of 48 incisional hernias were performed throughout the study period. The study patients reported lower short form health survey (SF-36) scores than the mean reference population, mainly dependent on the prevalence of major co-morbidities. There was no difference in SF-36 scores or a modified ventral hernia pain questionnaire (VHPQ) at 5 years of follow up between those with versus those without incisional hernias. Conclusions: A high primary fascial closure rate can be achieved with the vacuum-Assisted wound closure and meshmediated fascial traction technique in elderly, mainly non-Trauma patients, in need of prolonged open abdomen therapy.</p>},
  author       = {Acosta, Stefan and Björck, Martin and Petersson, Ulf},
  issn         = {1642-5758},
  keyword      = {Mesh-Mediated Fascial Traction,Negative Pressure Wound Therapy,Open Abdomen,Temporary Abdominal Closure,Vacuum},
  language     = {eng},
  month        = {06},
  number       = {2},
  pages        = {139--145},
  series       = {Anaesthesiology Intensive Therapy},
  title        = {Vacuum-Assisted wound closure and mesh-mediated fascial traction for open abdomen therapy - a systematic review},
  url          = {http://dx.doi.org/10.5603/AIT.a2017.0023},
  volume       = {49},
  year         = {2017},
}