The use of vacuum-assisted closure of abdominal wounds: a word of caution.
OBJECTIVE
Vacuum-assisted closure (VAC) has been used in our centre to aid the closure of abdominal wounds. The aim of this study was to examine the clinical outcome of patients in whom VAC therapy had been used in conjunction with laparostomy.


METHODS
All patients in whom VAC was used in the management of open abdominal wounds from November 2003 to March 2005 were included in this study.


RESULTS
There were 29 patients in the study. Nineteen (65.5%) needed ICU care. Six (20%) patients developed leakage of small bowel contents into the abdominal wound cavity because of intestinal fistulation during the VAC therapy. Four of the six (66%) died, all from multi-organ failure.


CONCLUSIONS
Our study has demonstrated a high incidence of intestinal leakage following VAC therapy. The reasons for this are multifactorial. We would recommend caution in using it on patients with bowel anastomoses or enterotomy repairs.
Rao
M
M
Department of Colorectal Surgery, Leeds General Infirmary, Leeds, UK.
Burke
D
D
Finan
P J
PJ
Sagar
P M
PM
D000007:Abdominal Injuries / Q000150:complications / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007813:Laparotomy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014618:Vacuum; D014945:Wound Healing