title: Promising results after vacuum-assisted wound closure and mesh-mediated fascial traction.
abstract: BACKGROUND
  Patients with an open abdomen (OA) present a major challenge to the surgeon. High mortality and associated complication rates have been reported depending on the specific method of temporary abdominal closure, the primary disorder and any co-morbidity. Vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) is a novel technique recently introduced for late fascial closure of the OA. In previous studies, the disease aetiologies were mainly vascular and visceral surgical disease and trauma. We report our results using VAWCM in a non-trauma patient population treated with an OA due to visceral surgical disease.
  
  
  METHODS
  Medical records of all patients in our department treated with VAWCM during the period from 1 August 2009 to 31 May 2011 were reviewed. All sixteen patients were non-trauma patients. The initial treatment was vacuum-assisted closure (VAC) (Abdominal Dressing System KCI, San Antonio, Texas, USA). VAWCM treatment was initiated if complete fascial closure could not be obtained with VAC.
  
  
  RESULTS
  Two patients died of multiple organ failure that was not associated with the VAWCM treatment. In one patient, treatment was terminated due to a very short life expectancy. We achieved a complete fascial closure rate in seven out of 16 patients. One patient had a pancreatic fistula at discharge that was not associated with the VAWCM treatment. No enteric fistulas occurred.
  
  
  CONCLUSIONS
  It seems that VAWCM can improve the rate of complete fascial closure after treatment with OA without increasing the mortality or the occurrence of enteric fistula compared with other kinds of temporary abdominal closure.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: Kirurgisk Afdeling, Hillerød Hospital, 3400 Hillerød, Denmark. kleifen@dadlnet.dk
authors.forename: Jakob
authors.initials: J
authors.lastname: Kleif
authors.forename: Rasmus
authors.initials: R
authors.lastname: Fabricius
authors.forename: Claus Anders
authors.initials: CA
authors.lastname: Bertelsen
authors.forename: Jens
authors.initials: J
authors.lastname: Bruun
authors.forename: Ismail
authors.initials: I
authors.lastname: Gögenur
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy; D013526:Surgical Mesh; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000628:therapy; D014143:Traction