{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T10:42:26Z","timestamp":1783420946534,"version":"3.54.6"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T00:00:00Z","timestamp":1612828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> The open abdomen (OA) is an important approach for managing intra-abdominal catastrophes and continues to be the standard of care. Complete fascial closure is an essential treatment objective and can be achieved by the use of different dynamic closure techniques. Both surgical technique and\u2014decision making are essential for optimal patient outcome in terms of fascial closure. The aim of this study was to analyse patients' outcome after the use of mesh-mediated fascial traction (MMFT) associated with negative pressure wound therapy (NPWT) and identify important factors that negatively influenced final fascial closure.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> A single center ambispective analysis was performed including all patients treated for an open abdomen in a tertiary referral center from 3\/2011 till 2\/2020. All patients with a minimum survival &amp;gt;24 h after initiation of treatment were analyzed. The data concerning patient management was collected and entered into the Open Abdomen Route of the European Hernia Society (EHS). Patient basic characteristics considering OA indication, primary fascial closure, as well as important features in surgical technique including time after index procedure to start mesh mediated fascial traction, surgical closure techniques and patients' long-term outcomes were analyzed.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Data were obtained from 152 patients who underwent open abdomen therapy (OAT) in a single center study. Indications for OAT as per-protocol analysis were sepsis (33.3%), abdominal compartment syndrome (31.6%), followed by peritonitis (24.2%), abdominal trauma (8.3%) and burst abdomen (2.4%). Overall fascial closure rate was 80% as in the per-protocol analysis. When patients that started OA management with MMFT and NPWT from the initial surgery a significantly better fascial closure rate was achieved compared to patients that started 3 or more days later (<jats:italic>p<\/jats:italic> &amp;lt; 0.001). An incisional hernia developed in 35.8% of patients alive with a median follow-up of 49 months (range 6\u201396 months).<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Our main findings emphasize the importance of a standardized treatment plan, initiated early on during management of the OA. The use of vacuum assisted closure in combination with MMFT showed high rates of fascial closure. Absence of initial intraperitoneal NPWT as well as delayed start of MMFT were risk factors for non-fascial closure. Initiation of OA with VACM should not be unnecessary delayed.<\/jats:p>","DOI":"10.3389\/fsurg.2020.606539","type":"journal-article","created":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T09:03:46Z","timestamp":1612861426000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":18,"title":["Early Initiation of a Standardized Open Abdomen Treatment With Vacuum Assisted Mesh-Mediated Fascial Traction Achieves Best Results"],"prefix":"10.3389","volume":"7","author":[{"given":"Frederik","family":"Berrevoet","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvio","family":"Lampaert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kashika","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamilya","family":"Jakipbayeva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stijn","family":"van Cleven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aude","family":"Vanlander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,2,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1097\/TA.0000000000001126","article-title":"What is the effectiveness of the negative pressure wound therapy (NPWT) in patients treated with open abdomen technique? A systematic review and meta-analysis","volume":"81","author":"Cirocchi","year":"2016","journal-title":"J Trauma Acute Care."},{"key":"B2","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.ijsu.2014.11.025","article-title":"Fascial closure after open abdomen: Initial indication and early revisions are decisive factors - A retrospective cohort study","volume":"13","author":"Lambertz","year":"2015","journal-title":"Int J Surg."},{"key":"B3","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/s13017-015-0032-7","article-title":"The role of the open abdomen procedure in managing severe abdominal sepsis: WSES position paper","volume":"12","author":"Sartelli","year":"2015","journal-title":"World J. Emerg. Surg."},{"key":"B4","doi-asserted-by":"publisher","first-page":"11","DOI":"10.3389\/fsurg.2018.00011","article-title":"Prevention of incisional hernias after open abdomen treatment","volume":"26","author":"Berrevoet","year":"2018","journal-title":"Front. Surg."},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-019-01205-2","article-title":"Underlying disease determines the risk of an open abdomen treatment, final closure, however, is determined by the surgical abdominal history","author":"Karhof","year":"2019","journal-title":"Eur J Trauma Emerg Surg."},{"key":"B6","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1177\/1457496916631853","article-title":"Amended classification of the open abdomen","volume":"105","author":"Bj\u00f6rck","year":"2016","journal-title":"Scand J Surg."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1154","DOI":"10.1007\/s00268-009-9996-3","article-title":"Classification - important step to improve management of patients with an open abdomen","volume":"33","author":"Bj\u00f6rck","year":"2009","journal-title":"World J Surg."},{"key":"B8","doi-asserted-by":"publisher","first-page":"139","DOI":"10.5603\/AIT.a2017.0023","article-title":"Vacuum-assisted wound closure and mesh-mediated fascial traction for open abdomen therapy - a systematic review","volume":"49","author":"Acosta","year":"2017","journal-title":"Anaesthesiol Intensive Ther."},{"key":"B9","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1007\/s00423-014-1240-4","article-title":"Management of the open abdomen using vacuum-assisted wound closure and mesh-mediated fascial traction","volume":"400","author":"Willms","year":"2015","journal-title":"Langenbecks Arch Surg."},{"key":"B10","doi-asserted-by":"publisher","first-page":"4717","DOI":"10.1007\/s00464-017-5547-4","article-title":"Delayed closure of open abdomen in septic patients treated with negative pressure wound therapy and dynamic fascial suture: the long-term follow-up study","volume":"31","author":"Hofmann","year":"2017","journal-title":"Surg Endosc."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1100","DOI":"10.1097\/TA.0000000000001452","article-title":"Open abdomen with vacuum-assisted wound closure and mesh-mediated fascial traction in patients with complicated diffuse secondary peritonitis: a single-center 8 year experience","volume":"82","author":"Tolonen","year":"2017","journal-title":"J Trauma Acute Care Surg."},{"key":"B12","doi-asserted-by":"publisher","first-page":"3044","DOI":"10.1007\/s00268-019-05166-w","article-title":"Management of open abdomen after trauma laparotomy: a comparative analysis of dynamic fascial traction and negative pressure wound therapy systems","volume":"43","author":"Wang","year":"2019","journal-title":"World J Surg."},{"key":"B13","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1007\/s00464-013-3251-6","article-title":"Delayed closure of open abdomen in septic patients is facilitated by combined negative pressure wound therapy and dynamic fascial suture","volume":"28","author":"Fortelny","year":"2014","journal-title":"Surg Endosc."},{"key":"B14","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s13017-018-0167-4","article-title":"The open abdomen in trauma and non-trauma patients: WSES guidelines","volume":"13","author":"Coccolini","year":"2018","journal-title":"World J Emerg Surg."},{"key":"B15","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1177\/000313481708300220","article-title":"Complications and mortality associated with temporary abdominal closure techniques: a systematic review and meta-analysis","volume":"83","author":"Cristaudo","year":"2017","journal-title":"Am Surg."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1679","DOI":"10.1007\/s00268-017-4354-3","article-title":"Vacuum-assisted wound closure with mesh-mediated fascial traction achieves better outcomes than vacuum-assisted wound closure alone: a comparative study","volume":"42","author":"Salamone","year":"2018","journal-title":"World J Surg."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1105","DOI":"10.1016\/j.ijsu.2014.08.396","article-title":"Systematic review and evidence based recommendations for the use of negative pressure wound therapy in the open abdomen","volume":"12","author":"Bruhin","year":"2014","journal-title":"Int J Surg."},{"key":"B18","doi-asserted-by":"publisher","first-page":"921","DOI":"10.1007\/s10029-018-1818-9","article-title":"EHS clinical guidelines on the management of the abdominal wall in the context of the open or burst abdomen","volume":"22","author":"Lopez-Cano","year":"2018","journal-title":"Hernia."},{"key":"B19","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1007\/s10029-012-0912-7","article-title":"EuraHS: the development of an international online platform for registration and outcome measurement of ventral abdominal wall hernia repair","volume":"16","author":"Muysoms","year":"2012","journal-title":"Hernia."},{"key":"B20","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1007\/s10029-017-1572-4","article-title":"The Open Abdomen Route by EuraHS: introduction of the data set and initial results of procedures and procedure-related complications","volume":"21","author":"Willms","year":"2017","journal-title":"Hernia."},{"key":"B21","doi-asserted-by":"publisher","first-page":"2133","DOI":"10.1007\/s00268-007-9222-0","article-title":"Vacuum-assisted wound closure and mesh-mediated fascial traction\u2013a novel technique for late closure of the open abdomen","volume":"31","author":"Petersson","year":"2007","journal-title":"World J Surg"},{"key":"B22","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s13017-018-0167-4","article-title":"The open abdomen in trauma and non-trauma patients: WSES guidelines","volume":"13","author":"Coccolini","year":"2018","journal-title":"World J Emerg Surg."},{"key":"B23","doi-asserted-by":"publisher","first-page":"2724","DOI":"10.1007\/s00268-008-9762-y","article-title":"Treatment of the open abdomen with the commercially available vacuum-assisted closure system in patients with abdominal sepsis: low primary closure rate","volume":"32","author":"Wondberg","year":"2008","journal-title":"World J Surg."},{"key":"B24","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1007\/s00268-008-9867-3","article-title":"Temporary closure of the open abdomen: a systematic review on delayed primary fascial closure in patients with an open abdomen","volume":"33","year":"2009","journal-title":"World J Surg."},{"key":"B25","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1111\/j.1742-481X.2011.00782.x","article-title":"Treatment of the open abdomen with topical negative pressure therapy: a retrospective study of 46 cases","volume":"8","author":"Caro","year":"2011","journal-title":"Int Wound J."},{"key":"B26","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1007\/s10029-020-02130-9","article-title":"Dynamic closure techniques for treatment of an open abdomen: an update","volume":"24","author":"Poortmans","year":"2020","journal-title":"Hernia."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1725","DOI":"10.1002\/bjs.8914","article-title":"Vacuum and mesh-mediated fascial traction for primary closure of the open abdomen in critically ill surgical patients","volume":"99","author":"Rasilainen","year":"2012","journal-title":"Br J Surg."},{"key":"B28","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1177\/000313481207800935","article-title":"The value of vacuum-assisted closure in septic patients treated with laparostomy","volume":"78","author":"Pliakos","year":"2012","journal-title":"Am Surg."},{"key":"B29","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1186\/s12893-017-0281-3","article-title":"Negative Pressure Wound Therapy versus modified Barker Vacuum Pack as temporary abdominal closure technique for Open Abdomen management: a four-year experience","volume":"17","author":"Montori","year":"2017","journal-title":"BMC Surg."},{"key":"B30","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1007\/s10029-012-0995-1","article-title":"Chemical components separation with botulinum toxin A: a novel technique to improve primary fascial closure rates of the open abdomen","volume":"17","author":"Zielinski","year":"2013","journal-title":"Hernia."},{"key":"B31","first-page":"12","article-title":"In: Truong D, Dressler D, Hallett M, editors","volume-title":"Chapter 3. Pharmacology of Botulinum Toxin Drugs","year":"2009"},{"key":"B32","first-page":"A4719","article-title":"Vacuum with mesh is a feasible temporary closure device after fascial dehiscence","volume":"60","author":"Bj\u00f8rsum-Meyer","year":"2013","journal-title":"Dan Med J."},{"key":"B33","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1007\/s10029-016-1534-2","article-title":"Abdominal wall integrity after open abdomen: long-term results of vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM)","volume":"20","author":"Willms","year":"2016","journal-title":"Hernia."},{"key":"B34","doi-asserted-by":"publisher","first-page":"2031","DOI":"10.1007\/s00268-013-2082-x","article-title":"One-year follow-up after open abdomen therapy with vacuum-assisted wound closure and mesh-mediated fascial traction","volume":"37","author":"Bjarnason","year":"2011","journal-title":"World J Surg."},{"key":"B35","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1177\/1457496918818979","article-title":"Vacuum-assisted wound closure and permanent onlay mesh-mediated fascial traction: a novel technique for the prevention of incisional hernia after open abdomen therapy including results from a retrospective case series","volume":"108","author":"Petersson","year":"2019","journal-title":"Scand J Surg."}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2020.606539\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T09:03:50Z","timestamp":1612861430000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2020.606539\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,9]]},"references-count":35,"alternative-id":["10.3389\/fsurg.2020.606539"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2020.606539","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,9]]},"article-number":"606539"}}