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Mesh mediated fascial traction

A Willms, S Schaaf, R Schwab, I Richardsen, D Bieler, B Wagner, C Güsgen
PURPOSE: The open abdomen has become a standard technique in the management of critically ill patients undergoing surgery for severe intra-abdominal conditions. Negative pressure and mesh-mediated fascial traction are commonly used and achieve low fistula rates and high fascial closure rates. In this study, long-term results of a standardised treatment approach are presented. METHODS: Fifty-five patients who underwent OA management for different indications at our institution from 2006 to 2013 were enrolled...
September 6, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Christian Beltzer, Alexander Eisenächer, Steffen Badendieck, Dietrich Doll, Markus Küper, Stefan Lenz, Björn Dirk Krapohl
INTRODUCTION: The optimal treatment concept for temporary abdominal closure (TAC) in critically ill visceral surgery patients with open abdomen (OA) continues to be unclear. The VACM (vacuum-assisted closure and mesh-mediated fascial traction) therapy seems to permit higher delayed primary fascial closure rates (FCR) than other TAC procedures. MATERIAL AND METHODS: Patients of our clinic (n=58) who were treated by application of a VAC/VACM treatment manual in the period from 2005 to 2008 were retrospectively analysed...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
A Seternes, L C Rekstad, S Mo, P Klepstad, D L Halvorsen, T Dahl, M Björck, A Wibe
BACKGROUND: Open abdomen treatment (OAT) is a significant burden for patients and is associated with considerable mortality. The primary aim of this study was to report survival and cause of mortality after OAT. Secondary aims were to evaluate length of stay (LOS) in intensive care unit (ICU) and in hospital, time to abdominal closure and major complications. METHODS: Retrospective review of prospectively registered patients undergoing OAT between October 2006 and June 2014 at Trondheim University Hospital, Norway...
August 19, 2016: World Journal of Surgery
M Kääriäinen, M Kuuskeri, M Helminen, H Kuokkanen
BACKGROUND AND AIMS: The open abdomen technique is a standard procedure in the treatment of intra-abdominal catastrophe. Achieving primary abdominal closure within the initial hospitalization is a main objective. This study aimed to analyze the success of closure rate and the effect of negative pressure wound therapy, mesh-mediated medial traction, and component separation on the results. We present the treatment algorithm used in our institution in open abdomen situations based on these findings...
August 15, 2016: Scandinavian Journal of Surgery: SJS
U Petersson, T Bjarnason, M Björck, A Montgomery, P Rogmark, M Svensson, K Sörelius, S Acosta
PURPOSE: To report incisional hernia (IH) incidence, abdominal wall (AW) discomfort and quality of life (QoL) 5 years after open abdomen treatment with vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM). METHODS: Five-year follow-up of patients included in a prospective study 2006-2009. The protocol included physical examination, patient interview, chart review, questionnaires on abdominal wall and stoma complaints and the SF-36 questionnaire...
October 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
J Camilo Correa, D Alejandro Mejía, N Duque, M Montoya J, C Morales Uribe
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...
April 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Qian Huang, Jieshou Li, Wan-Yee Lau
Open abdomen (OA) has been an effective treatment for abdominal catastrophes in traumatic and general surgery. However, management of patients with OA remains a formidable task for surgeons. The central goal of OA is closure of fascial defect as early as is clinically feasible without precipitating abdominal compartment syndrome. Historically, techniques such as packing, mesh, and vacuum-assisted closure have been developed to assist temporary abdominal closure, and techniques such as components separation, mesh-mediated traction, bridging fascial defect with permanent synthetic mesh, or biologic mesh have also been attempted to achieve early primary fascial closure, either alone or in combined use...
2016: Gastroenterology Research and Practice
S Acosta, A Wanhainen, M Björck
OBJECTIVES: The aim of this paper was to review the literature on temporary abdominal closure (TAC) after abdominal aortic aneurysm (AAA) repair. METHODS: This was a systematic review of observational studies. A PubMed, EMBASE and Cochrane search from 2007 to July 2015 was performed combining the Medical Subject Headings "aortic aneurysm" and "temporary abdominal closure", "delayed abdominal closure", "open abdomen", "abdominal compartment syndrome", "negative pressure wound therapy", or "vacuum assisted wound closure"...
March 2016: European Journal of Vascular and Endovascular Surgery
Masatoku Arai, Shigeki Kushimoto, Shiei Kim, Tomohiko Masuno, Jun Hagiwara, Hiromoto Ishii, Hiroyuki Yokota
Proper management of abdominal compartment syndrome and open abdomen is important for improving the survival of critically ill patients. However, in cases requiring a prolonged period of open abdomen, it is frequently difficult to perform definitive fascial closure due to lateralization of the abdominal musculature. We herein present a novel combined technique for managing open abdomen. A 74-year-old male with diffuse peritonitis was transferred to our department, after which a long period of open abdomen made it difficult to achieve fascial closure...
October 2015: Surgery Today
A C Lord, R Hompes, A Venkatasubramaniam, S Arnold
Management of the open abdomen has advanced significantly in recent years with the increasing use of vacuum assisted closure (VAC) techniques leading to increased rates of fascial closure. We present the case of a patient who suffered two complete abdominal wall dehiscences after an elective laparotomy, meaning primary closure was no longer possible. She was treated successfully with a VAC system combined with continuous medial traction using a Prolene(®) mesh. This technique has not been described before in the management of patients following wound dehiscence...
January 2015: Annals of the Royal College of Surgeons of England
J J Atema, S L Gans, M A Boermeester
BACKGROUND: Several challenging clinical situations in patients with peritonitis can result in an open abdomen (OA) and subsequent temporary abdominal closure (TAC). Indications and treatment choices differ among surgeons. The risk of fistula development and the possibility to achieve delayed fascial closure differ between techniques. The aim of this study was to review the literature on the OA and TAC in peritonitis patients, to analyze indications and to assess delayed fascial closure, enteroatmospheric fistula and mortality rate, overall and per TAC technique...
April 2015: World Journal of Surgery
Thordur Bjarnason, Agneta Montgomery, Stefan Acosta, Ulf Petersson
BACKGROUND: Classification of the open abdomen (OA) status is essential for clinical studies on the subject and may help to improve OA therapy. This is a validity and reliability analysis of the OA classification proposed by the World Society of the Abdominal Compartment Syndrome in 2013. METHODS: Prospective data on 111 consecutive OA patients treated with vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) was used. For validity analysis, OA grades were compared with fascial closure and mortality...
December 2014: World Journal of Surgery
A Willms, C Güsgen, S Schaaf, D Bieler, M von Websky, R Schwab
BACKGROUND: The open abdomen has become an accepted treatment option of critically ill patients with severe intra-abdominal conditions. Fascial closure is a particular challenge in patients with peritonitis. This study investigates whether fascial closure rates can be increased in peritonitis patients by using an algorithm that combines vacuum-assisted wound closure and mesh-mediated fascial traction. Moreover, fascial closure rates for patients with peritonitis, trauma or abdominal compartment system (ACS) are compared...
January 2015: Langenbeck's Archives of Surgery
P Petersson, A Montgomery, U Petersson
PURPOSE: Treatment guidelines for abdominal wound dehiscence (WD) are lacking. The primary aim of the study was to compare suture to mesh repair in WD patients concerning incisional hernia incidence. Secondary aims were to compare recurrent WD, morbidity, mortality and long-term abdominal wall complaints. METHODS: A retrospective chart review of 46 consecutive patients operated for WD between January 2010 and August 2012 was conducted. Physical examination and a questionnaire enquiry were performed in January 2013...
October 2014: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Qian Huang, Risheng Zhao, Chao Yue, Wei Wang, Yunzhao Zhao, Jianan Ren, Ning Li, Jie shou Li
BACKGROUND AND AIM: The open abdomen (OA) is associated with significant morbidity and mortality, and its management poses a formidable challenge. Inability to achieve primary closure of the abdominal wall is one of the most severe complications of this technique. Factors influencing primary fascial closure, however, are unknown. This study aims to explore the influence of fluid volume overload on the application of vacuum-assisted and mesh-mediated fascial traction (VAWCM) in OA treatment...
March 2014: Journal of Surgical Research
Thomas Bjørsum-Meyer, Mona Skarbye, Kenneth Højsgaard Jensen
INTRODUCTION: The open abdomen is a challenging condition and a temporary abdominal closure device is required in order to protect the intra-abdominal viscera. We aimed to evaluate the feasibility of a recent device: vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) after fascial dehiscence focusing on fascial closure rate, mortality and procedure-related complications. MATERIAL AND METHODS: We performed a retrospective study on 18 patients treated with VAWCM after fascial dehiscence who were consecutively admitted to the Department of Surgery, Slagelse Hospital, between October 2008 and October 2012...
November 2013: Danish Medical Journal
Thordur Bjarnason, A Montgomery, O Ekberg, S Acosta, M Svensson, A Wanhainen, M Björck, U Petersson
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...
September 2013: World Journal of Surgery
M Kääriäinen, H Kuokkanen
"Open abdomen" is a strategy used to avoid or treat abdominal compartment syndrome. It has reduced mortality both in trauma and non-trauma abdominal catastrophes but also has created a challenging clinical problem. Traditionally, open abdomen is closed in two phases; primarily with a free skin graft and later with a flap reconstruction. A modern trend is to close the abdomen within the initial hospitalization. This requires multi-professional co-operation. Temporary abdominal closure methods, e.g. negative pressure wound therapy alone or combined with mesh-mediated traction, have been developed to facilitate direct fascial closure...
2013: Scandinavian Journal of Surgery: SJS
A Leppäniemi, E Tukiainen
Complex abdominal wall defects refer to situations where simple ventral hernia repair is not feasible because the defect is very large, there is a concomitant infection or failed previous re-pair attempt, or if there is not enough original skin to cover the repair. Usually a complex abdominal wall repair is preceded by a period of temporary abdominal closure where the short-term aims include closure of the catabolic drain, protection of the viscera and preventing fistula formation, preventing bowel adherence to the abdominal wall, and enabling future fascial and skin closure...
2013: Scandinavian Journal of Surgery: SJS
C D Liapis, K G Moulakakis
No abstract text is available yet for this article.
June 2013: European Journal of Vascular and Endovascular Surgery
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