Systematic review and meta-analysis of the open abdomen and temporary abdominal closure techniques in non-trauma patients.

摘要: Several challenging clinical situations in patients with peritonitis can result an open abdomen (OA) and subsequent temporary abdominal closure (TAC). Indications treatment choices differ among surgeons. The risk of fistula development the possibility to achieve delayed fascial between techniques. aim this study was review literature on OA TAC patients, analyze indications assess closure, enteroatmospheric mortality rate, overall per technique. Electronic databases were searched for studies describing whom 50 % or more had a non-traumatic origin. search identified 74 78 patient series, comprising 4,358 which 3,461 (79 %) peritonitis. quality included low management differed considerably. Negative pressure wound therapy (NPWT) most frequent described technique (38 series). highest weighted rate found series NPWT continuous mesh suture mediated traction (6 463 patients: 73.1 %, 95 % confidence interval 63.3–81.0 %) dynamic retention sutures (5 77 73.6 %, 51.1–88.1 %). Weighted rates varied from 5.7 % after (2.2–14.1 %), 14.6 % (12.1–17.6 %) only, 17.2 % inlay (17.2–29.5 %). Although best results terms achieving shown traction, available evidence poor, uniform recommendations cannot be made.