Factors influencing the fascial closure rate after open abdomen treatment: Results from the European Hernia Society (EuraHS) Registry
PurposeDefinitive 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.MethodsA multi-center multivariable analysis of data from the Open Ab...
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| creator | Willms, A G Schwab, R von Websky M W Berrevoet, F Tartaglia, D Sörelius, K telny, R H Björck, M Monchal, T Brennfleck, F Bulian, D Beltzer, C Germer, C T Lock, J F Güsgen, C Schaaf, S Anger, F Fuhr, S Kiesel, M Schmidt, R Kalff, J C Vilz, T O Galatioto, C Cobuccio, L Hoffmann, A Schlitt, H J Heiss, M Muysoms, F Oldhafer, K Dietz, U Björck, Martin Vanlander, A |
| description | PurposeDefinitive 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.MethodsA 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).ResultsData 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 |
| doi_str_mv | 10.1007/s10029-020-02336-x |
| format | Article |
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There is a paucity of evidence on factors that promote or prevent definitive fascial closure.MethodsA 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).ResultsData 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.ConclusionThe 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.</description><identifier>ISSN: 1265-4906</identifier><identifier>EISSN: 1248-9204</identifier><identifier>DOI: 10.1007/s10029-020-02336-x</identifier><language>eng</language><publisher>Paris: Springer Nature B.V</publisher><subject>Abdomen ; Clinical trials ; Compartment syndrome ; Contamination ; Hernia ; Hernias ; Morbidity ; Patients ; Peritonitis ; Pressure ; Trauma ; Wounds</subject><ispartof>Hernia : the journal of hernias and abdominal wall surgery, 2022-02, Vol.26 (1), p.61-73</ispartof><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c121x-ec81a909ce3dd1954a329973de2aa196e9deaa318e6ec6e70b0dc17752aa5c5e3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids></links><search><creatorcontrib>Willms, A G</creatorcontrib><creatorcontrib>Schwab, R</creatorcontrib><creatorcontrib>von Websky M W</creatorcontrib><creatorcontrib>Berrevoet, F</creatorcontrib><creatorcontrib>Tartaglia, D</creatorcontrib><creatorcontrib>Sörelius, K</creatorcontrib><creatorcontrib>telny, R H</creatorcontrib><creatorcontrib>Björck, M</creatorcontrib><creatorcontrib>Monchal, T</creatorcontrib><creatorcontrib>Brennfleck, F</creatorcontrib><creatorcontrib>Bulian, D</creatorcontrib><creatorcontrib>Beltzer, C</creatorcontrib><creatorcontrib>Germer, C T</creatorcontrib><creatorcontrib>Lock, J F</creatorcontrib><creatorcontrib>Güsgen, C</creatorcontrib><creatorcontrib>Schaaf, S</creatorcontrib><creatorcontrib>Anger, F</creatorcontrib><creatorcontrib>Fuhr, S</creatorcontrib><creatorcontrib>Kiesel, M</creatorcontrib><creatorcontrib>Schmidt, R</creatorcontrib><creatorcontrib>Kalff, J C</creatorcontrib><creatorcontrib>Vilz, T O</creatorcontrib><creatorcontrib>Galatioto, C</creatorcontrib><creatorcontrib>Cobuccio, L</creatorcontrib><creatorcontrib>Hoffmann, A</creatorcontrib><creatorcontrib>Schlitt, H J</creatorcontrib><creatorcontrib>Heiss, M</creatorcontrib><creatorcontrib>Muysoms, F</creatorcontrib><creatorcontrib>Oldhafer, K</creatorcontrib><creatorcontrib>Dietz, U</creatorcontrib><creatorcontrib>Björck, Martin</creatorcontrib><creatorcontrib>Vanlander, A</creatorcontrib><title>Factors influencing the fascial closure rate after open abdomen treatment: Results from the European Hernia Society (EuraHS) Registry</title><title>Hernia : the journal of hernias and abdominal wall surgery</title><description>PurposeDefinitive 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.MethodsA 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).ResultsData 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.ConclusionThe 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.</description><subject>Abdomen</subject><subject>Clinical trials</subject><subject>Compartment syndrome</subject><subject>Contamination</subject><subject>Hernia</subject><subject>Hernias</subject><subject>Morbidity</subject><subject>Patients</subject><subject>Peritonitis</subject><subject>Pressure</subject><subject>Trauma</subject><subject>Wounds</subject><issn>1265-4906</issn><issn>1248-9204</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNotTctOwzAQtBBIlMIPcLLEBQ6BtZ04MTeEWopUCYnCudo6m5IqjYvtSO0H8N-Yx2FnRprZGcYuBdwKgPIuJJQmAwnplNLZ_oiNhMyrzEjIj3-0LrLcgD5lZyFsAKDKdTViX1O00fnA277pBupt2695_CDeYLAtdtx2LgyeuMdIHJtInrsd9RxXtdsmjp4wJhHv-SuFoYuBN95tfzsmg09Z7PmMfN8iXzjbUjzw62TgbHGTPtZtiP5wzk4a7AJd_POYvU8nb4-zbP7y9Pz4MM-skGKfka0EGjCWVF0LU-SopDGlqkkiCqPJ1ISoREWarKYSVlBbUZZFsgtbkBqzq7_enXefA4W43LjB92lyKbVSQkgoQX0DTQ9lzw</recordid><startdate>20220201</startdate><enddate>20220201</enddate><creator>Willms, A G</creator><creator>Schwab, R</creator><creator>von Websky M W</creator><creator>Berrevoet, F</creator><creator>Tartaglia, D</creator><creator>Sörelius, K</creator><creator>telny, R H</creator><creator>Björck, M</creator><creator>Monchal, T</creator><creator>Brennfleck, F</creator><creator>Bulian, D</creator><creator>Beltzer, C</creator><creator>Germer, C T</creator><creator>Lock, J F</creator><creator>Güsgen, C</creator><creator>Schaaf, S</creator><creator>Anger, F</creator><creator>Fuhr, S</creator><creator>Kiesel, M</creator><creator>Schmidt, R</creator><creator>Kalff, J C</creator><creator>Vilz, T O</creator><creator>Galatioto, C</creator><creator>Cobuccio, L</creator><creator>Hoffmann, A</creator><creator>Schlitt, H J</creator><creator>Heiss, M</creator><creator>Muysoms, F</creator><creator>Oldhafer, K</creator><creator>Dietz, U</creator><creator>Björck, Martin</creator><creator>Vanlander, A</creator><general>Springer Nature B.V</general><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20220201</creationdate><title>Factors influencing the fascial closure rate after open abdomen treatment: Results from the European Hernia Society (EuraHS) Registry</title><author>Willms, A G ; Schwab, R ; von Websky M W ; Berrevoet, F ; Tartaglia, D ; Sörelius, K ; telny, R H ; Björck, M ; Monchal, T ; Brennfleck, F ; Bulian, D ; Beltzer, C ; Germer, C T ; Lock, J F ; Güsgen, C ; Schaaf, S ; Anger, F ; Fuhr, S ; Kiesel, M ; Schmidt, R ; Kalff, J C ; Vilz, T O ; Galatioto, C ; Cobuccio, L ; Hoffmann, A ; Schlitt, H J ; 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K</creatorcontrib><creatorcontrib>Dietz, U</creatorcontrib><creatorcontrib>Björck, Martin</creatorcontrib><creatorcontrib>Vanlander, A</creatorcontrib><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Hernia : the journal of hernias and abdominal wall surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Willms, A G</au><au>Schwab, R</au><au>von Websky M W</au><au>Berrevoet, F</au><au>Tartaglia, D</au><au>Sörelius, K</au><au>telny, R H</au><au>Björck, M</au><au>Monchal, T</au><au>Brennfleck, F</au><au>Bulian, D</au><au>Beltzer, C</au><au>Germer, C T</au><au>Lock, J F</au><au>Güsgen, C</au><au>Schaaf, S</au><au>Anger, F</au><au>Fuhr, S</au><au>Kiesel, M</au><au>Schmidt, R</au><au>Kalff, J C</au><au>Vilz, T O</au><au>Galatioto, C</au><au>Cobuccio, L</au><au>Hoffmann, A</au><au>Schlitt, H J</au><au>Heiss, M</au><au>Muysoms, F</au><au>Oldhafer, K</au><au>Dietz, U</au><au>Björck, Martin</au><au>Vanlander, A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors influencing the fascial closure rate after open abdomen treatment: Results from the European Hernia Society (EuraHS) Registry</atitle><jtitle>Hernia : the journal of hernias and abdominal wall surgery</jtitle><date>2022-02-01</date><risdate>2022</risdate><volume>26</volume><issue>1</issue><spage>61</spage><epage>73</epage><pages>61-73</pages><issn>1265-4906</issn><eissn>1248-9204</eissn><abstract>PurposeDefinitive 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.MethodsA 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).ResultsData 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.ConclusionThe 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.</abstract><cop>Paris</cop><pub>Springer Nature B.V</pub><doi>10.1007/s10029-020-02336-x</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Abdomen Clinical trials Compartment syndrome Contamination Hernia Hernias Morbidity Patients Peritonitis Pressure Trauma Wounds |
| title | Factors influencing the fascial closure rate after open abdomen treatment: Results from the European Hernia Society (EuraHS) Registry |
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