{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:10:46Z","timestamp":1788930646985,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,11,16]],"date-time":"2017-11-16T00:00:00Z","timestamp":1510790400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2017,11,16]],"date-time":"2017-11-16T00:00:00Z","timestamp":1510790400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Open abdomen (OA) permits the application of damage control surgery principles when abdominal trauma, sepsis, severe acute peritonitis and abdominal compartmental syndrome (ACS) occur.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Non\u2010traumatic patients treated with OA between January 2010 and December 2015 were identified in a prospective database, and the data collected were retrospectively reviewed. Patients\u2019 records were collected from charts and the surgical and intensive care unit (ICU) registries. The Acosta \u201c<jats:italic>modified<\/jats:italic>\u201d technique was used to achieve fascial closure in <jats:italic>vacuum<\/jats:italic>\u2010<jats:italic>assisted wound closure and mesh<\/jats:italic>\u2010<jats:italic>mediated fascial traction<\/jats:italic> (VAWCM) patients. Sex, age, simplified acute physiology score II (SAPS II), abdominal compartmental syndrome (ACS), cardiovascular disease (CVD) and surgical technique performed were evaluated in a multivariate analysis for mortality and fascial closure prediction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety\u2010six patients with a median age of 69 (40\u201378) years were included in the study. Sixty\u2010nine patients (72%) underwent VAWCM. Forty\u2010one patients (68%) achieved primary fascia closure: two patients (5%) were treated with VAWC (37\u00a0median days) versus 39 patients (95%) who were treated with VAWCM (10\u00a0median days) (<jats:italic>p<\/jats:italic> = 0.0003). Forty\u2010eight patients underwent OA treatment due to ACS, and 24 patients (50%) survived compared to 36 patients (75%) from the \u201cother reasons\u201d group (<jats:italic>p<\/jats:italic> = 0.01). The ACS group required longer mechanical ventilator support (<jats:italic>p<\/jats:italic> = 0.006), length of stay in hospital (<jats:italic>p<\/jats:italic> = 0.005) and in ICU (<jats:italic>p<\/jats:italic> = 0.04) and had higher SAPS II scores (<jats:italic>p<\/jats:italic> = 0.0002).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The survival rate was 62%. ACS (<jats:italic>p<\/jats:italic> = 0.01), SAPS II (<jats:italic>p<\/jats:italic> = 0.004), sex (<jats:italic>p<\/jats:italic> = 0.01), pre\u2010existing CVD (<jats:italic>p<\/jats:italic> = 0.0007) and surgical technique (VAWC vs VAWCM) (<jats:italic>p<\/jats:italic> = 0.0009) were determined to be predictors of mortality. Primary fascial closure was obtained in 68% of cases. VAWCM was found to grant higher survival and primary fascial closure rate.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-017-4354-3","type":"journal-article","created":{"date-parts":[[2017,11,16]],"date-time":"2017-11-16T16:59:04Z","timestamp":1510851544000},"page":"1679-1686","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Vacuum\u2010Assisted Wound Closure with Mesh\u2010Mediated Fascial Traction Achieves Better Outcomes than Vacuum\u2010Assisted Wound Closure Alone: A Comparative Study"],"prefix":"10.1002","volume":"42","author":[{"given":"Giuseppe","family":"Salamone","sequence":"first","affiliation":[{"name":"General and Emergency Surgery \u2013 Policlinico P. 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