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The temporary abdominal closure techniques used for trauma patients: a systematic review and meta-analysis
PURPOSE: The choice of temporary abdominal closure (TAC) method affects the prognosis of trauma patients. Previous studies on TAC are challenging to extrapolate due to data heterogeneity. We aimed to conduct a systematic review and comparison of various TAC techniques. METHODS: We accessed web-based...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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The Korean Surgical Society
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10083346/ https://www.ncbi.nlm.nih.gov/pubmed/37051156 http://dx.doi.org/10.4174/astr.2023.104.4.237 |
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author | Heo, Yoonjung Kim, Dong Hun |
author_facet | Heo, Yoonjung Kim, Dong Hun |
author_sort | Heo, Yoonjung |
collection | PubMed |
description | PURPOSE: The choice of temporary abdominal closure (TAC) method affects the prognosis of trauma patients. Previous studies on TAC are challenging to extrapolate due to data heterogeneity. We aimed to conduct a systematic review and comparison of various TAC techniques. METHODS: We accessed web-based databases for studies on the clinical outcomes of TAC techniques. Recognized techniques, including negative-pressure wound therapy with or without continuous fascial traction, skin tension, meshes, Bogota bags, and Wittman patches, were classified via a method of closure such as skin-only closure vs. patch closure vs. vacuum closure; and via dynamics of treatment like static therapy (ST) vs. dynamic therapy (DT). Study endpoints included in-hospital mortality, definitive fascial closure (DFC) rate, and incidence of intraabdominal complications. RESULTS: Among 1,065 identified studies, 37 papers comprising 2,582 trauma patients met the inclusion criteria. The vacuum closure group showed the lowest mortality (13%; 95% confidence interval [CI], 6%–19%) and a moderate DFC rate (74%; 95% CI, 67%–82%). The skin-only closure group showed the highest mortality (35%; 95% CI, 7%–63%) and the highest DFC rate (96%; 95% CI, 93%–99%). In the second group analysis, DT showed better outcomes than ST for all endpoints. CONCLUSION: Vacuum closure was favorable in terms of in-hospital mortality, ventral hernia, and peritoneal abscess. Skin-only closure might be an alternative TAC method in carefully selected groups. DT may provide the best results; however, further studies are needed. |
format | Online Article Text |
id | pubmed-10083346 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | The Korean Surgical Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-100833462023-04-11 The temporary abdominal closure techniques used for trauma patients: a systematic review and meta-analysis Heo, Yoonjung Kim, Dong Hun Ann Surg Treat Res Original Article PURPOSE: The choice of temporary abdominal closure (TAC) method affects the prognosis of trauma patients. Previous studies on TAC are challenging to extrapolate due to data heterogeneity. We aimed to conduct a systematic review and comparison of various TAC techniques. METHODS: We accessed web-based databases for studies on the clinical outcomes of TAC techniques. Recognized techniques, including negative-pressure wound therapy with or without continuous fascial traction, skin tension, meshes, Bogota bags, and Wittman patches, were classified via a method of closure such as skin-only closure vs. patch closure vs. vacuum closure; and via dynamics of treatment like static therapy (ST) vs. dynamic therapy (DT). Study endpoints included in-hospital mortality, definitive fascial closure (DFC) rate, and incidence of intraabdominal complications. RESULTS: Among 1,065 identified studies, 37 papers comprising 2,582 trauma patients met the inclusion criteria. The vacuum closure group showed the lowest mortality (13%; 95% confidence interval [CI], 6%–19%) and a moderate DFC rate (74%; 95% CI, 67%–82%). The skin-only closure group showed the highest mortality (35%; 95% CI, 7%–63%) and the highest DFC rate (96%; 95% CI, 93%–99%). In the second group analysis, DT showed better outcomes than ST for all endpoints. CONCLUSION: Vacuum closure was favorable in terms of in-hospital mortality, ventral hernia, and peritoneal abscess. Skin-only closure might be an alternative TAC method in carefully selected groups. DT may provide the best results; however, further studies are needed. The Korean Surgical Society 2023-04 2023-03-31 /pmc/articles/PMC10083346/ /pubmed/37051156 http://dx.doi.org/10.4174/astr.2023.104.4.237 Text en Copyright © 2023, the Korean Surgical Society https://creativecommons.org/licenses/by-nc/4.0/Annals of Surgical Treatment and Research is an Open Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Heo, Yoonjung Kim, Dong Hun The temporary abdominal closure techniques used for trauma patients: a systematic review and meta-analysis |
title | The temporary abdominal closure techniques used for trauma patients: a systematic review and meta-analysis |
title_full | The temporary abdominal closure techniques used for trauma patients: a systematic review and meta-analysis |
title_fullStr | The temporary abdominal closure techniques used for trauma patients: a systematic review and meta-analysis |
title_full_unstemmed | The temporary abdominal closure techniques used for trauma patients: a systematic review and meta-analysis |
title_short | The temporary abdominal closure techniques used for trauma patients: a systematic review and meta-analysis |
title_sort | temporary abdominal closure techniques used for trauma patients: a systematic review and meta-analysis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10083346/ https://www.ncbi.nlm.nih.gov/pubmed/37051156 http://dx.doi.org/10.4174/astr.2023.104.4.237 |
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