Please select the eligibility criteria that correspond to the clinical trial below.
Title: Treatment of Subcutaneous Abdominal Wound Healing Impairment After Surgery Without Fascial Dehiscence by Vacuum Assisted Closure™(SAWHI-V.A.C.® Study) Versus Standard Conventional Wound Therapy
Brief Summary: This clinical study is performed in several German, Dutch and Belgian hospitals to evaluate the efficacy of Vacuum Assisted Closure® (V.A.C.®) for the treatment of postsurgical abdominal wound healing impairments after surgery. Therefore the underlying layer of fibrous tissue that permeates the internal organs must be intact.

Main outcome measure is the time until complete wound closure that sustained for a minimum of 14 days. Furthermore the therapy options will be examined regarding several other clinical, safety, patient reported and economic parameters.

Patients will be assigned equally and by chance to both treatment groups. Study participants as well as the attending doctors and nurses will be informed about the assignment to the respective treatment arm.

The primary outcome measure and some of the secondary parameters like reappearance of the wound and the development of the wound size over time, examined within an active study treatment time of 42 days, will be photographed and analysed under the use of a central computer system. The central analysing personal will not be informed about patient details or therapy allocation.

Patients with at first closed belly wounds with wound healing disorder in the postoperative course after surgery without an opening of the underlying layer of fibrous tissue are eligible to be included in the trial if the diagnosis of a wound healing impairment in the postoperative course is manifested as a wound with spontaneous dehiscence, a wound that requires an active reopening of the suture by the treating physician or a wound that cannot be closed by primary intention and requires further treatment to achieve permanent closure.

Study participants will be selected and enrolled within clinical surgical departments which provide the respective personal, structural and scientific background for the conduction of the trial project.

Trial therapy will be started in-hospital and may be continued in ambulatory care. It is very important to examine the therapy options also in the ambulant care setting thus study participants with good health who are able to continue the specific wound treatment in ambulant should be transferred to the ambulant service as soon as possible.


Options:
A: Inclusion Criteria:

* Written informed consent
* Coronary heart disease patients to transplant more than 2 vascular bridge
* The thigh groin following from the saphenous vein

Exclusion Criteria:

* Subjects does not agree to participate in clinical trials
* Subjects had a injury, operation history of Thigh
* Subjects having ever received chemotherapy before the surgery
* Subjects with known hypersensitivity to components of the surgical sticky membrane
B: Inclusion Criteria:

* Written informed consent
* Post-surgical subcutaneous abdominal wound healing impairment
* Minimum wound size eligible for the application of the randomized treatment- Inclusion, randomization, adequate wound pre-treatment (Debridement) and start of therapy within 48 hours after reopening of the wound, diagnosis for nonclosable wound or in case of spontaneous wound dehiscence

Exclusion Criteria:

* Age \< 18
* Noncompliance with study procedures, visit schedule and follow up
* Pregnancy
* Present or nonclosable defect of the abdominal fascia
* Any pre-existing or ongoing organ system failure, that cannot be stabilized or solved by appropriate medical treatment
* Necrotic tissue with eschar present
* Non-enteric and unexplored fistulas
* Malignancy of the wound
* Use of any other device based on the principle of negative pressure wound therapy on the study wound within ≤ 8 days prior to screening
* Competing therapies or procedures
* Simultaneous participation in other clinical trials
C: Inclusion Criteria:

* BMI \> 35
* Previous femoral exposure
* Undergoing lower-limb revascularization

Exclusion Criteria:

* Cannot obtain seal
* Non-primary wound closure
* Pre-existing infection
* Endovascular repair
D: Inclusion Criteria:

* Patients that have undergone cesarean section for delivery; have a BMI greater or equal to 35. All cases of cesarean section including primary and repeat, scheduled and urgent.

Exclusion Criteria:

* Patients who deliver vaginally; age less than 18 years old; silver allergy; non-English speaking

Answer: B