R Villalobos Mori1, Y Maestre González2, Mª Mias Carballal2, C Gas Ruiz2, G Protti Ruiz2, A Escartin Arias2, J J Olsina Kissler2. 1. Abdominal Wall Surgery Unit, General Surgery Department, Arnau de Vilanova University Hospital, Lleida University, 80 Rovira Roure Avenue, 25198, Lleida, Catalonia, Spain. rafovilla26@gmail.com. 2. Abdominal Wall Surgery Unit, General Surgery Department, Arnau de Vilanova University Hospital, Lleida University, 80 Rovira Roure Avenue, 25198, Lleida, Catalonia, Spain.
Abstract
BACKGROUND: Intended open abdomen is an option in cases of trauma and non-trauma patients. Nevertheless, after primary closure, incisional hernia rate is high. We describe a novel method, called COmbined and MOdified Definitive Abdominal closure (COMODA), a delayed primary closure which prevents incisional hernia. METHODS: A negative pressure wound therapy system is combined with a condensed polytetrafluoroethylene (cPTFE) mesh. TRIAL REGISTRATION: ISRCTN72678033. RESULTS: Ten male patients with a median age of 68.8 (43-87) years were included. Primary closure rate was 100% per protocol. The median number of procedures per patient was 5.7 (5-9). Primary closure was obtained in 20.8 (10-32) days and median hospital stay was 36.3 (18-52) days. Only one patient developed incisional hernia during a median follow-up of 27 (8-60) months. CONCLUSION: COMODA method allows for a high rate of delayed primary closure. It is safe and decreases the risk for developing an incisional hernia. However, a large number of patients are needed to support this conclusion.
BACKGROUND: Intended open abdomen is an option in cases of trauma and non-traumapatients. Nevertheless, after primary closure, incisional hernia rate is high. We describe a novel method, called COmbined and MOdified Definitive Abdominal closure (COMODA), a delayed primary closure which prevents incisional hernia. METHODS: A negative pressure wound therapy system is combined with a condensed polytetrafluoroethylene (cPTFE) mesh. TRIAL REGISTRATION: ISRCTN72678033. RESULTS: Ten male patients with a median age of 68.8 (43-87) years were included. Primary closure rate was 100% per protocol. The median number of procedures per patient was 5.7 (5-9). Primary closure was obtained in 20.8 (10-32) days and median hospital stay was 36.3 (18-52) days. Only one patient developed incisional hernia during a median follow-up of 27 (8-60) months. CONCLUSION: COMODA method allows for a high rate of delayed primary closure. It is safe and decreases the risk for developing an incisional hernia. However, a large number of patients are needed to support this conclusion.
Entities:
Keywords:
Incisional hernia; Intra-abdominal pressure; Open abdomen; Primary closure
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