Vacuum-assisted wound closure achieves early fascial closure of open abdomens after severe trauma.
BACKGROUND
This study reviews the efficacy of vacuum-assisted wound closure (VAWC) to obtain primary fascial closure of open abdomens after severe trauma.


METHODS
The study population included shock resuscitation patients who had open abdomens treated with VAWC. The VAWC dressing was changed at 2- to 3-day intervals and downsized as fascial closure was completed with interrupted suture. The Trauma Research Database and the medical records were reviewed for pertinent data.


RESULTS
Over 26 months, 35 patients with open abdomens were managed by VAWC. Six died early, leaving 29 patients who were discharged. Of these, 25 (86%) were successfully closed using VAWC at a mean of 7 +/- 1 days (range, 3-18 days). Of the four patients that failed VAWC, two developed fistulas. No patients developed evisceration, intra-abdominal abscess, or wound infection.


CONCLUSIONS
VAWC achieved early fascial closure in a high percentage of open abdomens, with an acceptable rate of complications.
Suliburk
James W
JW
Department of Surgery, University of Texas-Houston Medical School, 77030, USA.
Ware
Drue N
DN
Balogh
Zsolt
Z
McKinley
Bruce A
BA
Cocanour
Christine S
CS
Kozar
Rosemary A
RA
Moore
Frederick A
FA
Ivatury
Rao R
RR
D000007:Abdominal Injuries / Q000150:complications / Q000401:mortality / Q000601:surgery*; D000328:Adult; D001458:Bandages / Q000009:adverse effects / Q000592:standards; D003161:Compartment Syndromes / Q000209:etiology / Q000517:prevention & control*; D017577:Cutaneous Fistula / Q000209:etiology; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007813:Laparotomy / Q000009:adverse effects; D008297:Male; D011182:Postoperative Care / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D012151:Resuscitation; D012769:Shock / Q000209:etiology / Q000628:therapy; D017592:Skin Care / Q000009:adverse effects / Q000379:methods; D013396:Suction / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D016019:Survival Analysis; D013536:Suture Techniques; D013781:Texas / Q000453:epidemiology; D013997:Time Factors; D014193:Trauma Centers; D016896:Treatment Outcome; D014945:Wound Healing