Management of the open abdomen using combination therapy with ABRA and ABThera systems

Negative-pressure wound therapy for prevention and treatment of surgical-site infections after vascular surgery

“…The synergistic effect of adding a mesh-mediated fascial traction may avoid subsequent ventral hernia 16 -18 . Other fascial traction methods in combination with NPWT have shown similar high fascial closure rates 51,52 . The evidence base for different methods of managing open abdomen after AAA repair could be improved by performing multicentre RCTs.…”

“…The VACM seems a good alternative for the treatment of a clean, grade 1A, open abdomen after AAA repair. High fascial closure rates have been achieved with this technique in general surgery patients. If intestinal and/or infectious complications develop, the risks of delayed fascial closure, intestinal fistula and graft infection increase.…”

Vacuum-assisted wound closure and mesh-mediated fascial traction for open abdomen therapy — a systematic review

“…The fascial traction force has consisted of # 1-polydioxanone suture sutures (PDS) [18], vessel loops as dynamic sutures [17,19,20] or a dynamic closure system called the abdominal reapproximation anchor system (ABRA) [16]. A modified vacuum technique with successive closure of the fascia with non-resorbable single stitch sutures starting from the proximal to distal ends of the wound, called the narrowing technique, has also been described [21].…”

“…A modified vacuum technique with successive closure of the fascia with non-resorbable single stitch sutures starting from the proximal to distal ends of the wound, called the narrowing technique, has also been described [21]. Although all these studies report a high fascial closure rate [16][17][18][19][20][21], none of these techniques has spread to a large number of independent researchers, such as the VAWCM technique. Moreover, none of these techniques has been evaluated regarding long-term outcome in terms of abdominal wall discomforts and quality of life.…”

“…Reviews, editorials, commentaries, abstracts without full text articles, case series < 5 patients, irrelevant articles, articles not in English and those duplicating the same population were excluded. Seventeen full-text articles remained for assessment of eligibility, of which six articles were excluded: Vacuum and controlled fascial traction was used, but not mesh-mediated (n = 5) [16][17][18][19][20], modified NPWT (n = 1) [21], VAWCM therapy initiated if complete fascial closure not could be obtained with VAWC alone (n = 1) [22] and if the primary fascial closure rate per protocol and open abdomen time were not reported (n = 1) [23] (Fig. 1 [24]).…”