[Koblenz algorithm for open abdomen management].
A N Anipchenko1, A S Allakhverdyan1, A L Levchuk2
1Moscow Regional Research Clinical Institute, Moscow, Russia.
Khirurgiia
|July 16, 2021
Summary
The Koblenz algorithm for laparostomy treatment shows improved patient survival compared to VAC therapy. Further multi-center studies are needed to confirm its clinical effectiveness in managing laparostomy.
Area of Science:
- Surgery
- Trauma Surgery
- Abdominal Wall Reconstruction
Background:
- Laparostomy treatment remains controversial due to limited evidence.
- The Koblenz algorithm, developed by German military surgeons, is increasingly adopted in practice.
- Existing data on laparostomy management are insufficient for evidence-based guidelines.
Purpose of the Study:
- To analyze the clinical effectiveness of the Koblenz algorithm in laparostomy treatment.
- To compare the outcomes of the Koblenz algorithm with VAC therapy.
- To contribute data for future multi-center studies on laparostomy.
Main Methods:
- Systematic literature search across multiple databases (eLibrary, EZB, Cochrane, PubMed).
- Analysis of clinical effectiveness data for the Koblenz algorithm.
- Comparative analysis of mortality rates between treatment groups.
Main Results:
- Mortality was significantly lower with the Koblenz algorithm (33%) compared to VAC therapy (57%).
- The difference in mortality was statistically significant (OR 0.36, 95% CI 0.18-0.72, p=0.003).
- The Koblenz algorithm is utilized in approximately 50% of German civilian hospitals.
Conclusions:
- The Koblenz algorithm demonstrates promising results in reducing mortality for laparostomy patients.
- Further multi-center, evidence-based trials are essential to validate the efficacy of the Koblenz algorithm.
- The European Registry of Abdominal wall Hernias (EuraHS) database can support future research.
