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Comparative Study
. 2018 Jun;42(6):1679-1686.
doi: 10.1007/s00268-017-4354-3.

Vacuum-Assisted Wound Closure with Mesh-Mediated Fascial Traction Achieves Better Outcomes than Vacuum-Assisted Wound Closure Alone: A Comparative Study

Giuseppe Salamone  1 , Leo Licari  2 , Giovanni Guercio  1 , Albert Comelli  3 , Mirko Mangiapane  1 , Nicolò Falco  1 , Roberta Tutino  1 , Noemi Bagarella  1 , Sofia Campanella  1 , Calogero Porrello  1 , Roberto Gullo  1 , Gianfranco Cocorullo  1 , Gaspare Gulotta  1
Affiliations
Comparative Study

Vacuum-Assisted Wound Closure with Mesh-Mediated Fascial Traction Achieves Better Outcomes than Vacuum-Assisted Wound Closure Alone: A Comparative Study

Giuseppe Salamone et al. World J Surg. 2018 Jun.

Erratum in

Abstract

Background: Open abdomen (OA) permits the application of damage control surgery principles when abdominal trauma, sepsis, severe acute peritonitis and abdominal compartmental syndrome (ACS) occur.

Methods: Non-traumatic patients treated with OA between January 2010 and December 2015 were identified in a prospective database, and the data collected were retrospectively reviewed. Patients' records were collected from charts and the surgical and intensive care unit (ICU) registries. The Acosta "modified" technique was used to achieve fascial closure in vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) patients. Sex, age, simplified acute physiology score II (SAPS II), abdominal compartmental syndrome (ACS), cardiovascular disease (CVD) and surgical technique performed were evaluated in a multivariate analysis for mortality and fascial closure prediction.

Results: Ninety-six patients with a median age of 69 (40-78) years were included in the study. Sixty-nine patients (72%) underwent VAWCM. Forty-one patients (68%) achieved primary fascia closure: two patients (5%) were treated with VAWC (37 median days) versus 39 patients (95%) who were treated with VAWCM (10 median days) (p = 0.0003). Forty-eight patients underwent OA treatment due to ACS, and 24 patients (50%) survived compared to 36 patients (75%) from the "other reasons" group (p = 0.01). The ACS group required longer mechanical ventilator support (p = 0.006), length of stay in hospital (p = 0.005) and in ICU (p = 0.04) and had higher SAPS II scores (p = 0.0002).

Conclusions: The survival rate was 62%. ACS (p = 0.01), SAPS II (p = 0.004), sex (p = 0.01), pre-existing CVD (p = 0.0007) and surgical technique (VAWC vs VAWCM) (p = 0.0009) were determined to be predictors of mortality. Primary fascial closure was obtained in 68% of cases. VAWCM was found to grant higher survival and primary fascial closure rate.

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Conflict of interest statement

All authors are declare that they have no conflict of interest.

Figures

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Fig. 1
DCS flow chart
Fig. 2
Fig. 2
Björck classification
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References

    1. Balogh ZJ, Lumsdaine W, Moore E, et al. Postinjury abdominal compartment syndrome: from recognition to prevention. Lancet. 2014;384(9952):1466–1475. doi: 10.1016/S0140-6736(14)61689-5. - DOI - PubMed
    1. Malbrain ML, Cheatham ML, Kirkpatrick A, et al. Results from the international consensus of experts on intra-abdominal hypertension and abdominal compartment syndrome. Intensive Care Med. 2006;32:1722–1732. doi: 10.1007/s00134-006-0349-5. - DOI - PubMed
    1. Kirkpatrick AW, Roberts DJ, De Waele J, et al. Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome. Intensive Care Med. 2013;39:1190–1206. doi: 10.1007/s00134-013-2906-z. - DOI - PMC - PubMed
    1. Sugrue M, Jones F, Janjua KJ, et al. Temporary abdominal closure: a prospective evaluation of its effects on renal and respiratory physiology. J Trauma. 1998;45:914–921. doi: 10.1097/00005373-199811000-00013. - DOI - PubMed
    1. Bosscha K, Hulstaert PF, Hennipman A, et al. Fulminant acute pancreatitis and infected necrosis: results of open management of the abdomen and “planned” reoperations. J Am Coll Surg. 1998;187:255–262. doi: 10.1016/S1072-7515(98)00153-7. - DOI - PubMed

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