Vacuum assisted closure in open abdomen and deferred closure: experience in 23 patients

• Published in: Cirugia Española Vol. 90; no. 8; p. 506
• Main Authors: Pérez Domínguez, Lucinda, Pardellas Rivera, Hermelinda, Cáceres Alvarado, Nieves, López Saco, Angel, Rivo Vázquez, Angel, Casal Núñez, Enrique
• Format: Journal Article
• Language: Spanish
• Published: Spain 01-10-2012
• Subjects: Abdomen - surgery; Abdominal Wound Closure Techniques; Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Negative-Pressure Wound Therapy; Retrospective Studies
• DOI: 10.1016/j.ciresp.2012.03.009
• EISSN: 1578-147X

We analyse our experience and the results obtained with the use of vacuum assisted closure (VAC(®), KCI Clinic Spain SL) in the management of open abdomen.
We retrospectively reviewed the laparostomies performed between June 2006 and March 2011 using VAC(®) treatment in the Hospital Xeral-Cíes, Vigo.
We included 23 consecutive patients (18 males and 5 females) on whom the VAC(®) was used in the open abdomen due to different indications (abdominal trauma, peritonitis, pancreatitis, ischaemic disease or abdominal compartmental syndrome). The VAC(®) needed changing a mean of 3.1 times per patient (range 1-7), with total mean treatment duration of 14.8 days (2-43) until closure, primary closure being achieved in 18 out of 21 patients (86%). The mean hospital stay was 110.1 days (8-163) and 6 patients (26%) died during their hospital stay due to problems related to their underlying disease. Seven cases (30%) had complications during the VAC® therapy: 3 intra-abdominal abscesses (13%), 4 fistulas or suture dehiscence (17%), and 1 evisceration (4%).
VAC(®) therapy is simple to manage, with an acceptable rate of complication, particularly of intestinal fistulas, and a reduced mortality. Of the various systems available for the deferred closure of the abdomen, the VAC(®) has made considerable progress in the past few years, mainly due to its adaptable material, and its numerous advantages. Its use will possibly increase in the future.