Intensive care and health outcomes of open abdominal treatment: long-term results of vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM).

PURPOSE: The study's purpose is to evaluate the long-term outcome after vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) and to identify predictors of quality of life associated with intensive care.

METHODS: Fifty-five patients who underwent open abdomen management at our institution from 2006 to 2013 were prospectively enrolled in this study. After a median follow-up period of 3.8 years, 27 patients completed the 36-Item Short Form Survey (SF-36) quality of life questionnaire. As this is a report solely focused on quality of life, direct treatment-related outcome measures like mortality, closure rates, and incisional hernia development of this study cohort have been reported previously.

RESULTS: SF-36 physical role (54.6 ± 41.0 (0-100), p < 0.01), physical functioning (68.4 ± 29.5 (0-100), p = 0.01), and physical component summary (41.6 ± 13.0 (19-62), p = 0.01) scores for the patient population were significantly lower than normative scores. Significant correlations were found between physical functioning and total treatment costs (r = -0.66, p = 0.01), total units of packed red blood cells (r = -0.56, p = 0.04), and the complex intensive care scores (r = -0.50, p = 0.02). Simple and multiple regression analyses demonstrated that the complex intensive care score was the only predictor of physical functioning (R 2 = 0.50, β = -0.70, p = 0.02).

CONCLUSIONS: Despite high short-term mortality and morbidity rates for these critically ill patients, open abdomen treatment using VAWCM allows patients to recover to an acceptable long-term quality of life. The complex intensive care score can be used as a surrogate parameter for the global severity of illness and was the only predictor of physical functioning (SF-36).