Managing the Open Abdomen: Negative Pressure Closure Versus Mesh-mediated Fascial Traction Closure: a Randomized Trial

Overview

Journal Hernia

Publisher Springer

Date 2016 Feb 3

PMID 26833235

Citations 10

Authors

J Camilo Correa

D Alejandro Mejia

N Duque

M Montoya J

C Morales Uribe

Affiliations

Soon will be listed here.

Abstract

Purpose: To compare the effectiveness of abdominal wall closure using the vacuum-assisted closure (NPC) as described by Barker et al. with an institutional protocol using a double polyvinyl bag in the first surgery, which is changed in subsequent surgeries to a polyvinyl bag placed over the bowel loops and a prolene mesh attached to the abdominal fascia (MMFC).

Methods: Randomized controlled trial. Patients with open abdomen (OA) due to a traumatic or a medical cause were included in the study. Variables studied included demographics, indication for surgery, number of interventions, hospital length of stay (HLOS), ICU length of stay, abdominal wound care costs, complication rates, and method and time to definitive fascial closure.

Results: From June 2011 to April 2013, 75 patients were enrolled in the study. Patients who died within 48 h were excluded; therefore, 53 patients in total were assessed. NPC achieved fascial closure in 75% of patients, and MMFC achieved closure in 71.9% of patients. The closure rates in patients with OA secondary to medical causes (80% by NPC vs. 71.4% by MMFC) or traumatic causes (70% by NPC vs. 73.7% by MMFC) were similar in both treatment groups. There were no differences between the groups with respect to cause of OA, complications, length of hospital stay, or the length of stay in the intensive care unit.

Conclusion: MMFC is a method comparable to NPC for the temporary management of OA that results in similar closure and complication rates.

Citing Articles

Early placement of a non-invasive, pressure-regulated, fascial reapproximation device improves reduction of the fascial gap in open abdomens: a retrospective cohort study.

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Negative pressure wound therapy for managing the open abdomen in non-trauma patients.

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Abdominal and thoracic wall closure: damage control surgery's cinderella.

Rodriguez-Holguin F, Hadad A, Mejia D, Garcia A, Cevallos C, Himmler A Colomb Med (Cali). 2021; 52(2):e4144777.

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Negative pressure wound therapy in patients with wounds healing by secondary intention: a systematic review and meta-analysis of randomised controlled trials.

Zens Y, Barth M, Bucher H, Dreck K, Felsch M, Gross W Syst Rev. 2020; 9(1):238.

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A preliminary prospective study of patients who underwent vacuum-assisted and mesh-mediated fascial traction techniques for open abdomen management with negative fluid therapy: An observational study.

Tian W, Huang Q, Yao Z, Huang M, Yang F, Zhao Y Medicine (Baltimore). 2019; 98(35):e16617.

PMID: 31464898 PMC: 6736416. DOI: 10.1097/MD.0000000000016617.

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