Novel Method for Delayed Primary Closure and Incisional Hernia Prevention in Open Abdomen: COmbined and MOdified Definitive Abdominal Wall Closure (COMODA)

Overview

Journal Hernia

Publisher Springer

Date 2019 Apr 11

PMID 30968285

Citations 4

Authors

R Villalobos Mori

Y Maestre Gonzalez

MA Mias Carballal

C Gas Ruiz

G Protti Ruiz

A Escartin Arias

J J Olsina Kissler

Affiliations

Soon will be listed here.

Abstract

Background: Intended open abdomen is an option in cases of trauma and non-trauma patients. Nevertheless, after primary closure, incisional hernia rate is high. We describe a novel method, called COmbined and MOdified Definitive Abdominal closure (COMODA), a delayed primary closure which prevents incisional hernia.

Methods: A negative pressure wound therapy system is combined with a condensed polytetrafluoroethylene (cPTFE) mesh.

Trial Registration: ISRCTN72678033.

Results: Ten male patients with a median age of 68.8 (43-87) years were included. Primary closure rate was 100% per protocol. The median number of procedures per patient was 5.7 (5-9). Primary closure was obtained in 20.8 (10-32) days and median hospital stay was 36.3 (18-52) days. Only one patient developed incisional hernia during a median follow-up of 27 (8-60) months.

Conclusion: COMODA method allows for a high rate of delayed primary closure. It is safe and decreases the risk for developing an incisional hernia. However, a large number of patients are needed to support this conclusion.

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.

Naveed A, Martin N, Bawazeer M, Jastaniah A, Rezende-Neto J Trauma Surg Acute Care Open. 2024; 9(1):e001529.

PMID: 39411009 PMC: 11474681. DOI: 10.1136/tsaco-2024-001529.

Intra-abdominal hypertension and compartment syndrome after complex hernia repair.

Van Hoef S, Dries P, Allaeys M, Eker H, Berrevoet F Hernia. 2024; 28(3):701-709.

PMID: 38568348 DOI: 10.1007/s10029-024-02992-3.

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

Cheng Y, Wang K, Gong J, Liu Z, Gong J, Zeng Z Cochrane Database Syst Rev. 2022; 5:CD013710.

PMID: 35514120 PMC: 9073087. DOI: 10.1002/14651858.CD013710.pub2.

Dynamic closure techniques for treatment of an open abdomen: an update.

Poortmans N, Berrevoet F Hernia. 2020; 24(2):325-331.

PMID: 32020342 DOI: 10.1007/s10029-020-02130-9.

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