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Intensive care and health outcomes of open abdominal treatment: long-term results of vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM)
Purpose The study’s purpose is to evaluate the long-term outcome after vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) and to identify predictors of quality of life associated with intensive care. Methods Fifty-five patients who underwent open abdomen management at our insti...
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| Published in: | Langenbeck's archives of surgery 2017-05, Vol.402 (3), p.481-492 |
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| creator | Willms, A. Schaaf, S. Schwab, R. Richardsen, I. Jänig, C. Bieler, D. Wagner, B. Güsgen, C. |
| description | Purpose
The study’s purpose is to evaluate the long-term outcome after vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) and to identify predictors of quality of life associated with intensive care.
Methods
Fifty-five patients who underwent open abdomen management at our institution from 2006 to 2013 were prospectively enrolled in this study. After a median follow-up period of 3.8 years, 27 patients completed the 36-Item Short Form Survey (SF-36) quality of life questionnaire. As this is a report solely focused on quality of life, direct treatment-related outcome measures like mortality, closure rates, and incisional hernia development of this study cohort have been reported previously.
Results
SF-36 physical role (54.6 ± 41.0 (0–100),
p
|
| doi_str_mv | 10.1007/s00423-017-1575-8 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1884886915</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1884886915</sourcerecordid><originalsourceid>FETCH-LOGICAL-c344t-65289415fbfec01591ae521f7dcf6e18d479a57a7b71fd6ac1a0a44370506fc43</originalsourceid><addsrcrecordid>eNp9kctuFDEQRVuIiDzgA9ggL8PCxO6222520QiSSEFseCytGnc501G3PfiRiI_hX_FkhixZlaU6dUqu2zRvOfvAGVMXiTHRdpRxRblUkuoXzQkXnaStkPzl81t0x81pSveMsV4N4lVz3OpOt7IXJ82fG5_Rp-kBiYWIBPxINghz3pBQsg0LJhIcCVv0BNZjWCYPM8kRIS_o80cyB39HM8aFRExlzk_4A9hSFgopTSnjSB5DqV47h1QOO6p3QxccJ9j1HSQ7PXnB5il4cv7j8ufqy_vXzZGDOeGbQz1rvn_-9G11TW-_Xt2sLm-p7YTItJetHgSXbu3QMi4HDihb7tRoXY9cj0INIBWoteJu7MFyYFDPophkvbOiO2vO995tDL8KpmyWKVmcZ_AYSjJca6F1P3BZUb5HbQwpRXRmG6cF4m_DmdmlYvapmJqK2aVidJ15d9CXdf3z88S_GCrQ7oFUW_4Oo7kPJdZLp_9Y_wIe95pZ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1884886915</pqid></control><display><type>article</type><title>Intensive care and health outcomes of open abdominal treatment: long-term results of vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM)</title><source>Springer Nature</source><creator>Willms, A. ; Schaaf, S. ; Schwab, R. ; Richardsen, I. ; Jänig, C. ; Bieler, D. ; Wagner, B. ; Güsgen, C.</creator><creatorcontrib>Willms, A. ; Schaaf, S. ; Schwab, R. ; Richardsen, I. ; Jänig, C. ; Bieler, D. ; Wagner, B. ; Güsgen, C.</creatorcontrib><description>Purpose
The study’s purpose is to evaluate the long-term outcome after vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) and to identify predictors of quality of life associated with intensive care.
Methods
Fifty-five patients who underwent open abdomen management at our institution from 2006 to 2013 were prospectively enrolled in this study. After a median follow-up period of 3.8 years, 27 patients completed the 36-Item Short Form Survey (SF-36) quality of life questionnaire. As this is a report solely focused on quality of life, direct treatment-related outcome measures like mortality, closure rates, and incisional hernia development of this study cohort have been reported previously.
Results
SF-36 physical role (54.6 ± 41.0 (0–100),
p
< 0.01), physical functioning (68.4 ± 29.5 (0–100),
p
= 0.01), and physical component summary (41.6 ± 13.0 (19–62),
p
= 0.01) scores for the patient population were significantly lower than normative scores. Significant correlations were found between physical functioning and total treatment costs (
r
= −0.66,
p
= 0.01), total units of packed red blood cells (
r
= −0.56,
p
= 0.04), and the complex intensive care scores (
r
= −0.50,
p
= 0.02). Simple and multiple regression analyses demonstrated that the complex intensive care score was the only predictor of physical functioning (
R
2
= 0.50,
β
= −0.70,
p
= 0.02).
Conclusions
Despite high short-term mortality and morbidity rates for these critically ill patients, open abdomen treatment using VAWCM allows patients to recover to an acceptable long-term quality of life. The complex intensive care score can be used as a surrogate parameter for the global severity of illness and was the only predictor of physical functioning (SF-36).</description><identifier>ISSN: 1435-2443</identifier><identifier>EISSN: 1435-2451</identifier><identifier>DOI: 10.1007/s00423-017-1575-8</identifier><identifier>PMID: 28382564</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Abdominal Surgery ; Abdominal Wound Closure Techniques ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cardiac Surgery ; Critical Care ; Fasciotomy ; Female ; Follow-Up Studies ; General Surgery ; Humans ; Incisional Hernia - epidemiology ; Laparotomy - adverse effects ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Negative-Pressure Wound Therapy ; Original Article ; Postoperative Complications - epidemiology ; Prospective Studies ; Quality of Life ; Surgical Mesh ; Surveys and Questionnaires ; Thoracic Surgery ; Time Factors ; Traction ; Traumatic Surgery ; Treatment Outcome ; Vascular Surgery ; Young Adult</subject><ispartof>Langenbeck's archives of surgery, 2017-05, Vol.402 (3), p.481-492</ispartof><rights>Springer-Verlag Berlin Heidelberg 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c344t-65289415fbfec01591ae521f7dcf6e18d479a57a7b71fd6ac1a0a44370506fc43</citedby><cites>FETCH-LOGICAL-c344t-65289415fbfec01591ae521f7dcf6e18d479a57a7b71fd6ac1a0a44370506fc43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28382564$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Willms, A.</creatorcontrib><creatorcontrib>Schaaf, S.</creatorcontrib><creatorcontrib>Schwab, R.</creatorcontrib><creatorcontrib>Richardsen, I.</creatorcontrib><creatorcontrib>Jänig, C.</creatorcontrib><creatorcontrib>Bieler, D.</creatorcontrib><creatorcontrib>Wagner, B.</creatorcontrib><creatorcontrib>Güsgen, C.</creatorcontrib><title>Intensive care and health outcomes of open abdominal treatment: long-term results of vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM)</title><title>Langenbeck's archives of surgery</title><addtitle>Langenbecks Arch Surg</addtitle><addtitle>Langenbecks Arch Surg</addtitle><description>Purpose
The study’s purpose is to evaluate the long-term outcome after vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) and to identify predictors of quality of life associated with intensive care.
Methods
Fifty-five patients who underwent open abdomen management at our institution from 2006 to 2013 were prospectively enrolled in this study. After a median follow-up period of 3.8 years, 27 patients completed the 36-Item Short Form Survey (SF-36) quality of life questionnaire. As this is a report solely focused on quality of life, direct treatment-related outcome measures like mortality, closure rates, and incisional hernia development of this study cohort have been reported previously.
Results
SF-36 physical role (54.6 ± 41.0 (0–100),
p
< 0.01), physical functioning (68.4 ± 29.5 (0–100),
p
= 0.01), and physical component summary (41.6 ± 13.0 (19–62),
p
= 0.01) scores for the patient population were significantly lower than normative scores. Significant correlations were found between physical functioning and total treatment costs (
r
= −0.66,
p
= 0.01), total units of packed red blood cells (
r
= −0.56,
p
= 0.04), and the complex intensive care scores (
r
= −0.50,
p
= 0.02). Simple and multiple regression analyses demonstrated that the complex intensive care score was the only predictor of physical functioning (
R
2
= 0.50,
β
= −0.70,
p
= 0.02).
Conclusions
Despite high short-term mortality and morbidity rates for these critically ill patients, open abdomen treatment using VAWCM allows patients to recover to an acceptable long-term quality of life. The complex intensive care score can be used as a surrogate parameter for the global severity of illness and was the only predictor of physical functioning (SF-36).</description><subject>Abdominal Surgery</subject><subject>Abdominal Wound Closure Techniques</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cardiac Surgery</subject><subject>Critical Care</subject><subject>Fasciotomy</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>General Surgery</subject><subject>Humans</subject><subject>Incisional Hernia - epidemiology</subject><subject>Laparotomy - adverse effects</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Negative-Pressure Wound Therapy</subject><subject>Original Article</subject><subject>Postoperative Complications - epidemiology</subject><subject>Prospective Studies</subject><subject>Quality of Life</subject><subject>Surgical Mesh</subject><subject>Surveys and Questionnaires</subject><subject>Thoracic Surgery</subject><subject>Time Factors</subject><subject>Traction</subject><subject>Traumatic Surgery</subject><subject>Treatment Outcome</subject><subject>Vascular Surgery</subject><subject>Young Adult</subject><issn>1435-2443</issn><issn>1435-2451</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNp9kctuFDEQRVuIiDzgA9ggL8PCxO6222520QiSSEFseCytGnc501G3PfiRiI_hX_FkhixZlaU6dUqu2zRvOfvAGVMXiTHRdpRxRblUkuoXzQkXnaStkPzl81t0x81pSveMsV4N4lVz3OpOt7IXJ82fG5_Rp-kBiYWIBPxINghz3pBQsg0LJhIcCVv0BNZjWCYPM8kRIS_o80cyB39HM8aFRExlzk_4A9hSFgopTSnjSB5DqV47h1QOO6p3QxccJ9j1HSQ7PXnB5il4cv7j8ufqy_vXzZGDOeGbQz1rvn_-9G11TW-_Xt2sLm-p7YTItJetHgSXbu3QMi4HDihb7tRoXY9cj0INIBWoteJu7MFyYFDPophkvbOiO2vO995tDL8KpmyWKVmcZ_AYSjJca6F1P3BZUb5HbQwpRXRmG6cF4m_DmdmlYvapmJqK2aVidJ15d9CXdf3z88S_GCrQ7oFUW_4Oo7kPJdZLp_9Y_wIe95pZ</recordid><startdate>20170501</startdate><enddate>20170501</enddate><creator>Willms, A.</creator><creator>Schaaf, S.</creator><creator>Schwab, R.</creator><creator>Richardsen, I.</creator><creator>Jänig, C.</creator><creator>Bieler, D.</creator><creator>Wagner, B.</creator><creator>Güsgen, C.</creator><general>Springer Berlin Heidelberg</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170501</creationdate><title>Intensive care and health outcomes of open abdominal treatment: long-term results of vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM)</title><author>Willms, A. ; Schaaf, S. ; Schwab, R. ; Richardsen, I. ; Jänig, C. ; Bieler, D. ; Wagner, B. ; Güsgen, C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c344t-65289415fbfec01591ae521f7dcf6e18d479a57a7b71fd6ac1a0a44370506fc43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Abdominal Surgery</topic><topic>Abdominal Wound Closure Techniques</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cardiac Surgery</topic><topic>Critical Care</topic><topic>Fasciotomy</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>General Surgery</topic><topic>Humans</topic><topic>Incisional Hernia - epidemiology</topic><topic>Laparotomy - adverse effects</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Negative-Pressure Wound Therapy</topic><topic>Original Article</topic><topic>Postoperative Complications - epidemiology</topic><topic>Prospective Studies</topic><topic>Quality of Life</topic><topic>Surgical Mesh</topic><topic>Surveys and Questionnaires</topic><topic>Thoracic Surgery</topic><topic>Time Factors</topic><topic>Traction</topic><topic>Traumatic Surgery</topic><topic>Treatment Outcome</topic><topic>Vascular Surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Willms, A.</creatorcontrib><creatorcontrib>Schaaf, S.</creatorcontrib><creatorcontrib>Schwab, R.</creatorcontrib><creatorcontrib>Richardsen, I.</creatorcontrib><creatorcontrib>Jänig, C.</creatorcontrib><creatorcontrib>Bieler, D.</creatorcontrib><creatorcontrib>Wagner, B.</creatorcontrib><creatorcontrib>Güsgen, C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Langenbeck's archives of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Willms, A.</au><au>Schaaf, S.</au><au>Schwab, R.</au><au>Richardsen, I.</au><au>Jänig, C.</au><au>Bieler, D.</au><au>Wagner, B.</au><au>Güsgen, C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intensive care and health outcomes of open abdominal treatment: long-term results of vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM)</atitle><jtitle>Langenbeck's archives of surgery</jtitle><stitle>Langenbecks Arch Surg</stitle><addtitle>Langenbecks Arch Surg</addtitle><date>2017-05-01</date><risdate>2017</risdate><volume>402</volume><issue>3</issue><spage>481</spage><epage>492</epage><pages>481-492</pages><issn>1435-2443</issn><eissn>1435-2451</eissn><abstract>Purpose
The study’s purpose is to evaluate the long-term outcome after vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) and to identify predictors of quality of life associated with intensive care.
Methods
Fifty-five patients who underwent open abdomen management at our institution from 2006 to 2013 were prospectively enrolled in this study. After a median follow-up period of 3.8 years, 27 patients completed the 36-Item Short Form Survey (SF-36) quality of life questionnaire. As this is a report solely focused on quality of life, direct treatment-related outcome measures like mortality, closure rates, and incisional hernia development of this study cohort have been reported previously.
Results
SF-36 physical role (54.6 ± 41.0 (0–100),
p
< 0.01), physical functioning (68.4 ± 29.5 (0–100),
p
= 0.01), and physical component summary (41.6 ± 13.0 (19–62),
p
= 0.01) scores for the patient population were significantly lower than normative scores. Significant correlations were found between physical functioning and total treatment costs (
r
= −0.66,
p
= 0.01), total units of packed red blood cells (
r
= −0.56,
p
= 0.04), and the complex intensive care scores (
r
= −0.50,
p
= 0.02). Simple and multiple regression analyses demonstrated that the complex intensive care score was the only predictor of physical functioning (
R
2
= 0.50,
β
= −0.70,
p
= 0.02).
Conclusions
Despite high short-term mortality and morbidity rates for these critically ill patients, open abdomen treatment using VAWCM allows patients to recover to an acceptable long-term quality of life. The complex intensive care score can be used as a surrogate parameter for the global severity of illness and was the only predictor of physical functioning (SF-36).</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>28382564</pmid><doi>10.1007/s00423-017-1575-8</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Langenbeck's archives of surgery, 2017-05, Vol.402 (3), p.481-492 |
| issn | 1435-2443 1435-2451 |
| language | eng |
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| source | Springer Nature |
| subjects | Abdominal Surgery Abdominal Wound Closure Techniques Adolescent Adult Aged Aged, 80 and over Cardiac Surgery Critical Care Fasciotomy Female Follow-Up Studies General Surgery Humans Incisional Hernia - epidemiology Laparotomy - adverse effects Male Medicine Medicine & Public Health Middle Aged Negative-Pressure Wound Therapy Original Article Postoperative Complications - epidemiology Prospective Studies Quality of Life Surgical Mesh Surveys and Questionnaires Thoracic Surgery Time Factors Traction Traumatic Surgery Treatment Outcome Vascular Surgery Young Adult |
| title | Intensive care and health outcomes of open abdominal treatment: long-term results of vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) |
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