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Quality of life and hernia development 5 years after open abdomen treatment with vacuum-assisted wound closure and mesh-mediated fascial traction

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Abstract

Purpose

To report incisional hernia (IH) incidence, abdominal wall (AW) discomfort and quality of life (QoL) 5 years after open abdomen treatment with vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM).

Methods

Five-year follow-up of patients included in a prospective study 2006–2009. The protocol included physical examination, patient interview, chart review, questionnaires on abdominal wall and stoma complaints and the SF-36 questionnaire.

Results

Fifty-five (12 women, 43 men; median age 70 years) of 111 included patients were alive. Follow-up rate was 91 %. Cumulative IH incidence during the whole study was 62 %. One-third of the IHs was repaired. At 5-year follow-up 59 % of IHs were clinically detectable. AW symptoms were equivalent in patients with (15/23) and without (11/21) IH (p = 0.541). SF-36 scores were lower than population mean for component scores and all subscales except bodily pain. Patients with major co-morbidity had lower physical component score [31.6 (95 %, CI 25.6–37.4)] compared to those without [48.9 (95 %, CI 46.2–51.4)]. Major co-morbidity was not associated with IH (p = 0.56), AW symptoms (p = 0.54) or stoma (p = 0.10). Patients with IH or other AW symptoms had similar SF-36 results compared to those without, whereas patients with a stoma had >5 point lower mean scores for general health, social function and physical component score compared to those without.

Conclusions

VAWCM treatment results in high incidence of IH. However, at five years, there was no detectable difference in abdominal wall complaints and QoL in patients with IH compared to those without. Lower QoL appeared mainly to be associated with the presence of major co-morbidity.

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Author information

Authors and Affiliations

  1. Department of Clinical Sciences Malmö, Lund University, Lund, Sweden

    U. Petersson, T. Bjarnason, A. Montgomery, P. Rogmark & S. Acosta

  2. Department of Surgery, Skane University Hospital, Malmö, Sweden

    U. Petersson, A. Montgomery & P. Rogmark

  3. Department of Surgery, Kristianstad Hospital, Kristianstad, Sweden

    T. Bjarnason

  4. Section of Vascular Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden

    M. Björck & K. Sörelius

  5. Department of Surgery, Falu Hospital, Falun, Sweden

    M. Svensson

  6. Vascular Centre, Skane University Hospital, Malmö, Sweden

    S. Acosta

Authors
  1. U. Petersson
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  2. T. Bjarnason
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  3. M. Björck
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  4. A. Montgomery
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  5. P. Rogmark
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  6. M. Svensson
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  7. K. Sörelius
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  8. S. Acosta
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Corresponding author

Correspondence to U. Petersson.

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Funding

This study was not funded by grants or other contributions.

Conflict of interest

Author UP has received speaker honorarium from KCI. Author TB has received speaker honorarium from Smith and Nephew. Author SA has received speaker honorarium from Acelity. Author MB, AM, PR, MS and KS declare that they have no conflict of interest.

Ethical approval

The study was approved by the ethics committee of Lund University (Dnr 564/2005) and registered at www.clinicaltrials.gov (registration number: NCT00494793). All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Petersson, U., Bjarnason, T., Björck, M. et al. Quality of life and hernia development 5 years after open abdomen treatment with vacuum-assisted wound closure and mesh-mediated fascial traction. Hernia 20, 755–764 (2016). https://doi.org/10.1007/s10029-016-1516-4

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  • DOI: https://doi.org/10.1007/s10029-016-1516-4

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