Novel method for delayed primary closure and incisional hernia prevention in open abdomen: COmbined and MOdified Definitive Abdominal wall closure (COMODA)

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 inci...

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Bibliographic Details
Published in:Hernia : the journal of hernias and abdominal wall surgery 2020-04, Vol.24 (2), p.395-401
Main Authors: Villalobos Mori, R., Maestre González, Y., Mias Carballal, Mª, Gas Ruiz, C., Protti Ruiz, G., Escartin Arias, A., Olsina Kissler, J. J.
Format: Article
Language:English
Subjects:
Abdomen
Abdominal Surgery
Abdominal wall
Abdominal Wall - surgery
Adult
Aged
Aged, 80 and over
Forum on Complexities in Hernia
Hernia
Hernia, Ventral - etiology
Hernia, Ventral - prevention & control
Hernias
How-I-Do-It
Humans
Incisional Hernia - etiology
Incisional Hernia - prevention & control
ISRCTN
ISRCTN72678033
Male
Medicine
Medicine & Public Health
Methylmethacrylates - administration & dosage
Middle Aged
Negative-Pressure Wound Therapy
Open Abdomen Techniques - adverse effects
Open Abdomen Techniques - methods
Patients
Polytetrafluoroethylene
Polytetrafluoroethylene - administration & dosage
Povidone - administration & dosage
Surgical Mesh
Trauma
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Summary: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.
ISSN:1265-4906
1248-9204
DOI:10.1007/s10029-019-01948-2