@article{WillmsSchwabvonWebskyetal.2022,
  author    = {Willms, A. G. and Schwab, R. and von Websky, M. W. and Berrevoet, F. and Tartaglia, D. and S{\"o}relius, K. and Fortelny, R. H. and Bj{\"o}rck, M. and Monchal, T. and Brennfleck, F. and Bulian, D. and Beltzer, C. and Germer, C. T. and Lock, J. F.},
  title     = {Factors influencing the fascial closure rate after open abdomen treatment: Results from the European Hernia Society (EuraHS) Registry. Surgical technique matters},
  series = {Hernia},
  volume    = {26},
  journal   = {Hernia},
  number    = {1},
  organization    = {EURAHS Open Abdomen Group},
  issn      = {1265-4906},
  doi       = {10.1007/s10029-020-02336-x},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-234871},
  pages     = {61-73},
  year      = {2022},
  abstract  = {Purpose Definitive fascial closure is an essential treatment objective after open abdomen treatment and mitigates morbidity and mortality. There is a paucity of evidence on factors that promote or prevent definitive fascial closure. Methods A multi-center multivariable analysis of data from the Open Abdomen Route of the European Hernia Society included all cases between 1 May 2015 and 31 December 2019. Different treatment elements, i.e. the use of a visceral protective layer, negative-pressure wound therapy and dynamic closure techniques, as well as patient characteristics were included in the multivariable analysis. The study was registered in the International Clinical Trials Registry Platform via the German Registry for Clinical Trials (DRK00021719). Results Data were included from 630 patients from eleven surgical departments in six European countries. Indications for OAT were peritonitis (46\%), abdominal compartment syndrome (20.5\%), burst abdomen (11.3\%), abdominal trauma (9\%), and other conditions (13.2\%). The overall definitive fascial closure rate was 57.5\% in the intention-to-treat analysis and 71\% in the per-protocol analysis. The multivariable analysis showed a positive correlation of negative-pressure wound therapy (odds ratio: 2.496, p < 0.001) and dynamic closure techniques (odds ratio: 2.687, p < 0.001) with fascial closure and a negative correlation of intra-abdominal contamination (odds ratio: 0.630, p = 0.029) and the number of surgical procedures before OAT (odds ratio: 0.740, p = 0.005) with DFC. Conclusion The clinical course and prognosis of open abdomen treatment can significantly be improved by the use of treatment elements such as negative-pressure wound therapy and dynamic closure techniques, which are associated with definitive fascial closure.},
  language  = {en}
}
@article{DietzWichelmannWunderetal.2012,
  author    = {Dietz, U. A. and Wichelmann, C. and Wunder, C. and Kauczok, J. and Spor, L. and Strauß, A. and Wildenauer, R. and Jurowich, C. and Germer, C. T.},
  title     = {Early repair of open abdomen with a tailored two-component mesh and conditioning vacuum packing: a safe alternative to the planned giant ventral hernia},
  series = {Hernia},
  volume    = {16},
  journal   = {Hernia},
  number    = {4},
  doi       = {10.1007/s10029-012-0919-0},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-126732},
  pages     = {451-460},
  year      = {2012},
  abstract  = {Purpose Once open abdomen therapy has succeeded, the problem of closing the abdominal wall must be addressed. We present a new four-stage procedure involving the application of a two-component mesh and vacuum conditioning for abdominal wall closure of even large defects. The aim is to prevent the development of a giant ventral hernia and the eventual need for the repair of the abdominal wall. Methods Nineteen of 62 patients treated by open abdomen over a two-year period could not receive primary abdominal wall closure. To achieve closure in these patients, we applied the following four-stage procedure: stage 1: abdominal damage control and conditioning of the abdominal wall; stage 2: attachment of a tailored two-component mesh of polyglycolic acid (PGA) and large pore polypropylene (PP) in intraperitoneal position (IPOM) plus placement of a vacuum bandage; stage 3: vacuum therapy for 3-4 weeks to allow granulation of the mesh and optimization of dermatotraction; stage 4: final skin suture. During stage 3, eligible patients were weaned from respirator and mobilized. Results The abdominal wall gap in the 19 patients ranged in size from 240 cm2 to more than 900 cm2. An average of 3.44 vacuum dressing changes over 19 days were required to achieve 60-100 \% granulation of the surface area, so final skin suture could be made. Already in stage 3, 14 patients (73.68 \%) could be weaned from respirator an average of 6.78 days after placement of the two-component mesh; 6 patients (31.57 \%) could be mobilized on the edge of the bed and/or to a bedside chair after an average of 13 days. No mesh-related hematomas, seromas, or intestinal fistulas were observed. Conclusion The four-stage procedure presented here is a viable option for achieving abdominal wall closure in patients treated with open abdomen, enabling us to avoid the development of planned giant ventral hernias. It has few complications and has the special advantage of allowing mobilization of the patients before final skin closure. Long-term course in a large number of patients must still confirm this result.},
  language  = {en}
}
@article{DietzWichelmannWunderetal.2012,
  author    = {Dietz, U. A. and Wichelmann, C. and Wunder, C. and Kauczok, J. and Spor, L. and Strauß, A. and Wildenauer, R. and Jurowich, C. and Germer, C. T.},
  title     = {Early repair of open abdomen with a tailored two-component mesh and conditioning vacuum packing: a safe alternative to the planned giant ventral hernia},
  series = {Hernia},
  volume    = {16},
  journal   = {Hernia},
  number    = {4},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-124686},
  pages     = {451-460},
  year      = {2012},
  abstract  = {Purpose Once open abdomen therapy has succeeded, the problem of closing the abdominal wall must be addressed. We present a new four-stage procedure involving the application of a two-component mesh and vacuum conditioning for abdominal wall closure of even large defects. The aim is to prevent the development of a giant ventral hernia and the eventual need for the repair of the abdominal wall. Methods Nineteen of 62 patients treated by open abdomen over a two-year period could not receive primary abdominal wall closure. To achieve closure in these patients, we applied the following four-stage procedure: stage 1: abdominal damage control and conditioning of the abdominal wall; stage 2: attachment of a tailored two-component mesh of polyglycolic acid (PGA) and large pore polypropylene (PP) in intraperitoneal position (IPOM) plus placement of a vacuum bandage; stage 3: vacuum therapy for 3-4 weeks to allow granulation of the mesh and optimization of dermatotraction; stage 4: final skin suture. During stage 3, eligible patients were weaned from respirator and mobilized. Results The abdominal wall gap in the 19 patients ranged in size from 240 cm2 to more than 900 cm2. An average of 3.44 vacuum dressing changes over 19 days were required to achieve 60-100 \% granulation of the surface area, so final skin suture could be made. Already in stage 3, 14 patients (73.68 \%) could be weaned from respirator an average of 6.78 days after placement of the two-component mesh; 6 patients (31.57 \%) could be mobilized on the edge of the bed and/or to a bedside chair after an average of 13 days. No mesh-related hematomas, seromas, or intestinal fistulas were observed. Conclusion The four-stage procedure presented here is a viable option for achieving abdominal wall closure in patients treated with open abdomen, enabling us to avoid the development of planned giant ventral hernias. It has few complications and has the special advantage of allowing mobilization of the patients before final skin closure. Long-term course in a large number of patients must still confirm this result.},
  language  = {en}
}