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EHS clinical guidel...
EHS clinical guidelines on the management of the abdominal wall in the context of the open or burst abdomen
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- López-Cano, M. (author)
- Vall d'Hebron University Hospital
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- García-Alamino, J. M. (author)
- University of Oxford
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- Antoniou, S. A. (author)
- Royal Devon & Exeter Hospital
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- Bennet, D. (author)
- Royal Bournemouth Hospital
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- Dietz, U. A. (author)
- Cantonal Hospital of Olten
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- Ferreira, F. (author)
- Pedro Hispano Hospital,Centro Hospitalar Universitário Porto
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- Fortelny, R. H. (author)
- Sigmund Freud Private University,Wilhelminenspital
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- Hernandez-Granados, P. (author)
- Hospital Universitario Fundación Alcorcón
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- Miserez, M. (author)
- University Hospitals Leuven
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- Montgomery, A. (author)
- Lund University,Lunds universitet,Kirurgi,Forskargrupper vid Lunds universitet,Surgery,Lund University Research Groups
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- Morales-Conde, S. (author)
- University Hospital Virgen del Rocío
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- Muysoms, F. (author)
- Maria Middelares Hospital
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- Pereira, J. A. (author)
- Pompeu Fabra University
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Schwab, R. (author)
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- Slater, N. (author)
- Radboud University Nijmegen
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- Vanlander, A. (author)
- Ghent University Hospital
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- Van Ramshorst, G. H. (author)
- Netherlands Cancer Institute
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- Berrevoet, F. (author)
- Ghent University Hospital
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(creator_code:org_t)
- 2018-09-03
- 2018
- English.
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In: Hernia. - : Springer Science and Business Media LLC. - 1265-4906 .- 1248-9204. ; 22:6, s. 921-939
- Related links:
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Subject headings
Close
- Purpose: To provide guidelines for all surgical specialists who deal with the open abdomen (OA) or the burst abdomen (BA) in adult patients both on the methods used to close the musculofascial layers of the abdominal wall, and regarding possible materials to be used. Methods: The guidelines were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach including publications up to January 2017. When RCTs were available, outcomes of interest were quantitatively synthesized by means of a conventional meta-analysis. When only observational studies were available, a meta-analysis of proportions was done. The guidelines were written using the AGREE II instrument. Results: For many of the Key Questions that were researched, there were no high quality studies available. While some strong recommendations could be made according to GRADE, the guidelines also contain good practice statements and clinical expertise guidance which are distinct from recommendations that have been formally categorized using GRADE. Recommendations: When considering the OA, dynamic closure techniques should be prioritized over the use of static closure techniques (strong recommendation). However, for techniques including suture closure, mesh reinforcement, component separation techniques and skin grafting, only clinical expertise guidance was provided. Considering the BA, a clinical expertise guidance statement was advised for dynamic closure techniques. Additionally, a clinical expertise guidance statement concerning suture closure and a good practice statement concerning mesh reinforcement during fascial closure were proposed. The role of advanced techniques such as component separation or relaxing incisions is questioned. In addition, the role of the abdominal girdle seems limited to very selected patients.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- Abdominal wall closure
- Burst abdomen
- Evisceration
- Fascial dehiscence
- Guidelines
- Hernia
- Open abdomen
Publication and Content Type
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- ref (subject category)
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Hernia
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To the university's database
- By the author/editor
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López-Cano, M.
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García-Alamino, ...
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Antoniou, S. A.
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Bennet, D.
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Dietz, U. A.
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Ferreira, F.
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Fortelny, R. H.
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Hernandez-Granad ...
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Miserez, M.
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Montgomery, A.
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Morales-Conde, S ...
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Muysoms, F.
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Pereira, J. A.
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Schwab, R.
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Slater, N.
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Vanlander, A.
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Van Ramshorst, G ...
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Berrevoet, F.
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Surgery
- Articles in the publication
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Hernia
- By the university
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Lund University