Quality of life and hernia development 5 years after open abdomen treatment with vacuum-assisted wound closure and mesh-mediated fascial traction.
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).



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.



Fifty-five (12 women, 43 men; median age 70 years) of 111 included patients were alive. Follow-up rate was 91 %. Cumulative IH incidence during the whole study was 62 %. One-third of the IHs was repaired. At 5-year follow-up 59 % of IHs were clinically detectable. AW symptoms were equivalent in patients with (15/23) and without (11/21) IH (p = 0.541). SF-36 scores were lower than population mean for component scores and all subscales except bodily pain. Patients with major co-morbidity had lower physical component score [31.6 (95 %, CI 25.6-37.4)] compared to those without [48.9 (95 %, CI 46.2-51.4)]. Major co-morbidity was not associated with IH (p = 0.56), AW symptoms (p = 0.54) or stoma (p = 0.10). Patients with IH or other AW symptoms had similar SF-36 results compared to those without, whereas patients with a stoma had >5 point lower mean scores for general health, social function and physical component score compared to those without.



VAWCM treatment results in high incidence of IH. However, at five years, there was no detectable difference in abdominal wall complaints and QoL in patients with IH compared to those without. Lower QoL appeared mainly to be associated with the presence of major co-morbidity.
Department of Clinical Sciences Malmö, Lund University, Lund, Sweden. ulf.a.petersson@telia.com.|Department of Surgery, Skane University Hospital, Malmö, Sweden. ulf.a.petersson@telia.com.
U
U
Petersson
Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.|Department of Surgery, Kristianstad Hospital, Kristianstad, Sweden.
T
T
Bjarnason
Section of Vascular Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
M
M
Björck
Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.|Department of Surgery, Skane University Hospital, Malmö, Sweden.
A
A
Montgomery
Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.|Department of Surgery, Skane University Hospital, Malmö, Sweden.
P
P
Rogmark
Department of Surgery, Falu Hospital, Falun, Sweden.
M
M
Svensson
Section of Vascular Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
K
K
Sörelius
Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.|Vascular Centre, Skane University Hospital, Malmö, Sweden.
S
S
Acosta
D034861:Abdominal Wall / Q000601:surgery*; D058107:Abdominal Wound Closure Techniques / Q000009:adverse effects*; D000368:Aged; D004766:Enterostomy / Q000009:adverse effects; D005205:Fascia; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000069290:Incisional Hernia / Q000209:etiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000009:adverse effects*; D011446:Prospective Studies; D011788:Quality of Life; D013526:Surgical Mesh; D014143:Traction
Incisional hernia; Mesh-mediated fascial traction; Open abdomen; Quality of life; SF-36; Vacuum-assisted wound closure