[New application of v.a.C. (vacuum assisted closure) in the abdominal cavity in case of open abdomen therapy].
OBJECTIVE
The problem of the temporary vacuum assisted closure (V.A.C.) of open abdomen situation is that the fluids, following the negative pressure, pass the abdominal cavity and in case of a local infection disseminate over the whole abdominal cavity.


METHODS
The usual open abdominal wound V.A.C. technique was modified by using an auxiliary, independently operating V.A.C. system positioned intra-abdominally and connected with a separate drainage tube introduced into the lateral abdominal wall. This arrangement prevents further spreading of a local intra-abdominal infection in case of a necrotising pancreatitis after traumatic pancreas rupture.


RESULTS
The drainage volumes were comparable from superficial and intra-abdominal V.A.C. system. A total of 30 reoperations were necessary due to a leasion of the pancreas before a primary closure of the open abdominal wound could be applied after 72 days. No bowel fistulas or intra-abdominal abscess formations were observed. The follow-up have not shown any hernia of the abdominal wall up to the present.


CONCLUSIONS
Additional intra-abdominally positioned V.A.C. system with an own drainage system supports open abdomen therapy with the standard abdominal V.A.C. system and prevents dissemination of intra-abdominal infection.
Labler
L
L
Klinik für Unfallchirurgie, Departement Chirurgie, Universitätsspital Zürich, Zürich, Schweiz. ludwig.labler@chi.usz.ch
Keel
M
M
Trentz
O
O
D000007:Abdominal Injuries / Q000601:surgery*; D034861:Abdominal Wall / Q000601:surgery; D000328:Adult; D003646:Debridement / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008838:Microcomputers; D009104:Multiple Trauma / Q000601:surgery; D009779:Occlusive Dressings; D010179:Pancreas / Q000293:injuries*; D010180:Pancreatectomy; D019283:Pancreatitis, Acute Necrotizing / Q000601:surgery*; D010538:Peritonitis / Q000601:surgery*; D012086:Reoperation; D025321:Surgery, Computer-Assisted / Q000295:instrumentation; D013530:Surgical Wound Infection / Q000601:surgery*; D013536:Suture Techniques / Q000295:instrumentation*; D014618:Vacuum; D014945:Wound Healing / Q000502:physiology