title: The open abdomen and temporary abdominal closure systems--historical evolution and systematic review.
abstract: OBJECTIVE
  Several techniques for temporary abdominal closure have been developed. We systematically review the literature on temporary abdominal closure to ascertain whether the method can be tailored to the indication.
  
  
  METHODS
  Medline, Embase, the Cochrane Central Register of Controlled Trials and relevant meeting abstracts until December 2009 were searched using the following headings: open abdomen, laparostomy, VAC (vacuum assisted closure), TNP (topical negative pressure), fascial closure, temporary abdominal closure, fascial dehiscence and deep wound dehiscence. The data were analysed by closure technique and aetiology. The primary end-points included delayed fascial closure and in-hospital mortality. The secondary end-points were intra-abdominal complications.
  
  
  RESULTS
  The search identified 106 papers for inclusion. The techniques described were VAC (38 series), mesh/sheet (30 series), packing (15 series), Wittmann patch (eight series), Bogotá bag (six series), dynamic retention sutures (three series), zipper (15 series), skin only and locking device (one series each). The highest facial closure rates were seen with the Wittmann patch (78%), dynamic retention sutures (71%) and VAC (61%).
  
  
  CONCLUSIONS
  Temporary abdominal closure has evolved from simple packing to VAC based systems. In the absence of sepsis Wittmann patch and VAC offered the best outcome. In its presence VAC had the highest delayed primary closure and the lowest mortality rates. However, due to data heterogeneity only limited conclusions can be drawn from this analysis.
authors.affiliation: Department of General Surgery, Victoria Hospital, Fife NHS Trust, Kirkcaldy, UK. aamin1@nhs.net
authors.forename: A J
authors.initials: AJ
authors.lastname: Quyn
authors.forename: C
authors.initials: C
authors.lastname: Johnston
authors.forename: D
authors.initials: D
authors.lastname: Hall
authors.forename: A
authors.initials: A
authors.lastname: Chambers
authors.forename: N
authors.initials: N
authors.lastname: Arapova
authors.forename: S
authors.initials: S
authors.lastname: Ogston
authors.forename: A I
authors.initials: AI
authors.lastname: Amin
mesh_terms: D018806:APACHE; D000005:Abdomen / Q000601:surgery*; D000071938:Fasciotomy; D017052:Hospital Mortality; D006801:Humans; D007813:Laparotomy / Q000379:methods*; D013529:Surgical Wound Dehiscence / Q000517:prevention & control; D013536:Suture Techniques