Article: A. G. WILLMS (GERMANY

Management of the open abdomen using vacuum-assisted wound closure and mesh-mediated fascial traction

MANAGEMENT OF THE OPEN ABDOMEN

The open abdomen has become a standard technique in the management of critically ill patients with severe intra-abdominal conditions. Fascial closure is a particular challenge after completion of open abdomen management. Since the open abdomen is used for the management of patients with perforating abdominal trauma in the damage control setting, it is a subject of major importance in military medicine. Military surgeons need a simple and standardised treatment approach that provides good and reproducible results and is associated with low complication rates. In addition, it must be suitable for the treatment of patients on military operations abroad, during medical evacuation, and in military hospitals at home.
In 2006, we introduced an algorithm that we have strictly applied in the management of open abdomen patients. This study investigates whether fascial closure rates can be improved by using this algorithm that combines vacuum-assisted wound closure and mesh-mediated fascial traction. Moreover, fascial closure rates for patients with peritonitis, trauma or abdominal compartment syndrome (ACS) are compared .