Vacuum Assisted Wound Closure (VAWC) and Mesh Mediated Fascial Traction

NCT ID: NCT00494793

Last Updated: 2017-12-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

111 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-04-01

Study Completion Date

2015-04-01

Brief Summary

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The purpose of this multicenter trial is to prospectively evaluate a novel combination of vacuum assisted wound closure (VAWC) and mesh mediated fascial traction for closure of open abdomens.

Detailed Description

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Open abdomen treatment often results in difficulties in closing the abdomen. Highest closure rates are seen with the vacuum assisted wound closure (VAWC) technique. Failures with this technique is occasionally experienced, especially in cases with severe visceral swelling needing longer treatment periods with open abdomen. A novel combination of vacuum assisted wound closure and mesh mediated fascial traction for managing the open abdomen was therefore developed and initially tested in a small pilot-like study with encouraging results with late primary closure of the abdomens in all seven patients.

In this multicenter study we prospectively evaluate the technique.

Inclusion criteria:

All patients treated with open abdomen at the 4 participating hospitals are registered, and only those patients who have commenced therapy with VAWC and mesh mediated fascial traction will be included in the study in an intention to treat model.

Exclusion criteria:

Treatment of open abdomen with other techniques.

Method:

* The first period of 2-5 days only the abdominal VAWC dressing is applied.
* On day 3-10 a polypropylene mesh is sutured to the fascial edges, between the two layers of the VAWC system, and tightened.
* The VAWC dressing is changed and the mesh tightened every 2-3 days, resulting in gradual approximation of the fascial edges.
* Finally the mesh is removed and the fascia is closed.
* At closure the wound to suture length is registered.

Primary endpoint:

Frequency of primary fascial closure.

Secondary endpoints:

* study of factors associated with failure of fascial closure and in-hospital mortality,
* abdominal pressure variation attributable to the use of the technique,
* duration of treatment with open abdomen,
* frequency of incisional hernia after one and five years.

Duration of the study:

3-5 years. Enrollment of open abdomen cases.

Follow-up schedule for patients:

* Clinical evaluation at 1 and 5 years.
* CT-examination at 1 year.

Conditions

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Open Abdomen Fascial Closure

Keywords

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Open abdomen Fascial closure Vacuum assisted wound closure Mesh Abdominal compartment syndrome Intraabdominal pressure Incisional hernia

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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VAWC and mesh mediated fascial traction

This is a study aiming to evaluate one technique for temporary abdominal closure for open abdomen therapy in all patients applicable according to the inclusion criteria

Group Type OTHER

VAWC and mesh mediated fascial traction

Intervention Type PROCEDURE

The first period of 2-5 days only the abdominal VAWC dressing is applied. On day 3-10 a polypropylene mesh is sutured to the fascial edges, between the two layers of the VAWC system, and tightened.

The VAWC dressing is changed and the mesh tightened every 2-3 days, resulting in gradual approximation of the fascial edges.

Finally the mesh is removed and the fascia is closed

Interventions

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VAWC and mesh mediated fascial traction

The first period of 2-5 days only the abdominal VAWC dressing is applied. On day 3-10 a polypropylene mesh is sutured to the fascial edges, between the two layers of the VAWC system, and tightened.

The VAWC dressing is changed and the mesh tightened every 2-3 days, resulting in gradual approximation of the fascial edges.

Finally the mesh is removed and the fascia is closed

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* open abdomen patients with midline incisions, where vacuum assisted wound closure system and mesh mediated fascial traction is applicable

Exclusion Criteria

* open abdomen patients treated otherwise
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Uppsala University Hospital

OTHER

Sponsor Role collaborator

Gävle Hospital

OTHER

Sponsor Role collaborator

Falu Hospital

OTHER

Sponsor Role collaborator

KCI Europe Holding B.V.

INDUSTRY

Sponsor Role collaborator

The Swedish Research Council

OTHER_GOV

Sponsor Role collaborator

Skane University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Ulf Petersson

MD, PhD, Ass prof

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ulf Petersson, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Surgery, Malmö University Hospital, Sweden

Locations

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Department of Surgery, Falu Hospital

Falun, , Sweden

Site Status

Department of Surgery, Gävle Hospital

Gävle, , Sweden

Site Status

Department of Surgery, Malmö University Hospital

Malmo, , Sweden

Site Status

Department of Vascular Surgery, Malmö University Hospital

Malmo, , Sweden

Site Status

Department of Surgery, Uppsala University Hospital

Uppsala, , Sweden

Site Status

Countries

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Sweden

References

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Bjarnason T, Montgomery A, Ekberg O, Acosta S, Svensson M, Wanhainen A, Bjorck M, Petersson U. One-year follow-up after open abdomen therapy with vacuum-assisted wound closure and mesh-mediated fascial traction. World J Surg. 2013 Sep;37(9):2031-8. doi: 10.1007/s00268-013-2082-x.

Reference Type DERIVED
PMID: 23703638 (View on PubMed)

Sorelius K, Wanhainen A, Acosta S, Svensson M, Djavani-Gidlund K, Bjorck M. Open abdomen treatment after aortic aneurysm repair with vacuum-assisted wound closure and mesh-mediated fascial traction. Eur J Vasc Endovasc Surg. 2013 Jun;45(6):588-94. doi: 10.1016/j.ejvs.2013.01.041. Epub 2013 Mar 1.

Reference Type DERIVED
PMID: 23465456 (View on PubMed)

Other Identifiers

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EPNLund 564/2005

Identifier Type: -

Identifier Source: org_study_id