Negative pressure wound therapy for the open abdomen

A meta-analysis of 4,303 patients reported delayed primary fascial closure rates of 58% (95% confidence interval [CI] 51 to 65) for negative pressure wound therapy (NPWT), 78% (95% CI 56 to 94) for Wittmann patch, 44% (95% CI 27 to 61) for zipper, 36% (95% CI 26 to 46) for mesh, 28% (95% CI 8 to 55) for Bogota bag and 13% (95% CI 3 to 28) for packing. A non-randomised comparative study of 578 patients treated by NPWT or other temporary abdominal closure techniques reported delayed primary fascial closure rates of 45% (84 out of 187) and 61% (114 out of 187) respectively (p=0.002, matched pair analysis).

The non-randomised comparative study of 578 patients treated by NPWT or other temporary abdominal closure techniques reported that 14% (27 out of 187) and 11% (20 out of 187) of patients respectively needed prosthetic replacement of the abdominal wall (p=0.28, matched pair analysis). A case series of 111 patients reported that 7% (8 out of 111) of patients needed abdominal wall reconstruction with a polypropylene mesh.

The specialist advisers listed key efficacy outcomes as reduction of exudate from the open abdomen, early fascial closure, shorter length of hospital stay, lower mortality, lower rate of secondary procedures to reconstruct the abdominal wall and improvement in patients' quality of life.