title: Retrospective analysis of a VACM (vacuum-assisted closure and mesh-mediated fascial traction) treatment manual for temporary abdominal wall closure - results of 58 consecutive patients.
abstract: BACKGROUND
  The optimal treatment concept for temporary abdominal closure (TAC) in critically ill visceral surgery patients with open abdomen (OA) continues to be unclear. The VACM (vacuum-assisted closure and mesh-mediated fascial traction) therapy seems to permit higher delayed primary fascial closure rates (FCR) than other TAC procedures.
  
  
  METHODS
  Patients of our clinic (n=58) who were treated by application of a VAC/VACM treatment manual in the period from 2005 to 2008 were retrospectively analysed.
  
  
  RESULTS
  The overall FCR of all patients was 48.3% (95% confidence interval: 34.95-61.78). An FCR of 61.3% was achieved in patients who had a vicryl mesh implanted at the fascial level (VACM therapy) in the course of treatment. Mortality among patients treated with VACM therapy was 45.2% (95% CI: 27.32-63.97).
  
  
  CONCLUSIONS
  The results of our own study confirm the results of previous studies which showed an acceptable FCR among non-trauma patients who were treated with VACM therapy. VACM therapy currently appears to be the treatment regime of choice for patients with OA requiring TAC.
authors.affiliation: Bundeswehr Hospital Ulm, Department of General, Visceral and Thorax Surgery, Ulm, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Beltzer
authors.affiliation: Bundeswehr Hospital Berlin, Department of General, Visceral and Thorax Surgery, Berlin, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Eisenächer
authors.affiliation: Bundeswehr Hospital Berlin, Department of General, Visceral and Thorax Surgery, Berlin, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Badendieck
authors.affiliation: St. Marienhospital, Vechta, Department of Colorectal Surgery, Vechta, Germany.
authors.forename: Dietrich
authors.initials: D
authors.lastname: Doll
authors.affiliation: Bundeswehr Hospital Berlin, Department of General, Visceral and Thorax Surgery, Berlin, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Küper
authors.affiliation: Klinikum Nauen, Department of General and Visceral Surgery, Nauen, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Lenz
authors.affiliation: St. Marien-Krankenhaus, Berlin, Department of Plastic and Hand Surgery, Berlin, Germany.
authors.forename: Björn Dirk
authors.initials: BD
authors.lastname: Krapohl
keywords: fascial closure rate; laparostoma; mesh-mediated fascial traction; open abdomen; peritonitis; temporary abdominal closure; vacuum-assisted closure