Fluid volume overload negatively influences delayed primary facial closure in open abdomen management

Huang, Qian; Zhao, Risheng; Yue, Chao; Wang, Wei; Zhao, Yunzhao; Ren, Jianan; Li, Ning; Li, Jie Shou

doi:10.1016/j.jss.2013.09.032

Cited by 40 publications

(34 citation statements)

References 18 publications

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“…Ten series described patients managed with combined TAC systems. NPWT was used alone in 32 studies [ 37 – 68 ], and in 6 studies, NWPT is combined with fascial traction (mesh or sutures) [ 69 – 74 ] and eight series described the use of meshes (non-absorbable and/or absorbable) [ 75 – 81 ]. Six series reported about the Bogota-bag use [ 75 , 82 – 86 ]; five, about Zipper [ 87 – 91 ]; and other five, about dynamic retention sutures [ 92 – 96 ].…”

Section: Methodsmentioning

confidence: 99%

The role of open abdomen in non-trauma patient: WSES Consensus Paper

et al. 2017

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The open abdomen (OA) is defined as intentional decision to leave the fascial edges of the abdomen un-approximated after laparotomy (laparostomy). The abdominal contents are potentially exposed and therefore must be protected with a temporary coverage, which is referred to as temporal abdominal closure (TAC). OA use remains widely debated with many specific details deserving detailed assessment and clarification. To date, in patients with intra-abdominal emergencies, the OA has not been formally endorsed for routine utilization; although, utilization is seemingly increasing. Therefore, the World Society of Emergency Surgery (WSES), Abdominal Compartment Society (WSACS) and the Donegal Research Academy united a worldwide group of experts in an international consensus conference to review and thereafter propose the basis for evidence-directed utilization of OA management in non-trauma emergency surgery and critically ill patients. In addition to utilization recommendations, questions with insufficient evidence urgently requiring future study were identified.

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Section: Methodsmentioning

confidence: 99%

The role of open abdomen in non-trauma patient: WSES Consensus Paper

et al. 2017

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“…The fascial closure rate was higher and the related complication rate was lower than the VAC treatment alone or the mesh traction technique alone. In our practice [ 77 ], the VAWCM technique can be successfully used in septic patients even when the wound was complex and/or contaminated. The complete fascial closure rate was 60% and the technique-related complications were few.…”

Section: Temporary Abdominal Closure Techniquesmentioning

confidence: 99%

“…The principle using VAWCM as a technique for temporary abdominal closure after laparotomy has been described [ 73 – 77 ]. In brief, in a patient whose abdomen was left open, a sterile perforated plastic sheet was placed intra-abdominally to cover the viscera and then an oval-shaped polypropylene mesh is sutured to the fascial edges using a running 0 monofilament suture.…”

Section: Temporary Abdominal Closure Techniquesmentioning

confidence: 99%

Techniques for Abdominal Wall Closure after Damage Control Laparotomy: From Temporary Abdominal Closure to Early/Delayed Fascial Closure—A Review

Huang

Lau

2016

Gastroenterology Research and Practice

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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. The objective of this review is to present the challenges of these techniques for OA with a goal of early primary fascial closure, when the patient's physiological condition allows.

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“…Vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) seemed to be a promising technique providing a higher DPFC rate and few complications after long-term treatment of OA [ 10 – 12 ]. It has become a routine temporary abdominal closure (TAC) technique for open septic abdomen at our institutions [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

VAWCM-Instillation Improves Delayed Primary Fascial Closure of Open Septic Abdomen

Tao

Ren

et al. 2014

Gastroenterology Research and Practice

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Background. Failure to achieve delayed primary fascial closure (DPFC) is one of the main complications of open abdomen (OA), certainly when abdominal sepsis is present. This retrospective cohort study aims to evaluate the effect of combined therapy of vacuum-assisted mesh-mediated fascial traction and topical instillation (VAWCM-instillation) on DPFC in the open septic abdomen. Methods. The patients with abdominal sepsis who underwent OA using VAWCM were included and divided into the instillation and noninstillation (control) groups. The DPFC rate and other outcomes were compared between the two groups. Results. Between 2007 and 2013, 73 patients with open septic abdomen were treated with VAWCM-instillation and 61 cases with VAWCM-only. The DPFC rate in the instillation group was significantly increased (63% versus 41%, P = 0.011). The mortality with OA was similar (24.6% versus 23%, P = 0.817) between the two groups. However, time to DPFC (P = 0.003) and length of stay in hospital (P = 0.022) of the survivals were significantly decreased in the instillation group. In addition, VAWCM-instillation (OR 1.453, 95% CI 1.222–4.927, P = 0.011) was an independent influencing factor related to successful DPFC. Conclusions. VAWCM-instillation could improve the DPFC rate but could not decrease the mortality in the patients with open septic abdomen.

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Fluid volume overload negatively influences delayed primary facial closure in open abdomen management

Cited by 40 publications

References 18 publications

The role of open abdomen in non-trauma patient: WSES Consensus Paper

The role of open abdomen in non-trauma patient: WSES Consensus Paper

Techniques for Abdominal Wall Closure after Damage Control Laparotomy: From Temporary Abdominal Closure to Early/Delayed Fascial Closure—A Review

VAWCM-Instillation Improves Delayed Primary Fascial Closure of Open Septic Abdomen

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