[Vacuum-assisted abdominal closure: its role in the treatment of complex abdominal and perineal wounds. Experience in 48 patients].
BACKGROUND
Vacuum-assisted closure (VAC) is a promising approach for the management of complex abdominal and perineal wounds. This paper summarizes our experience with this therapeutic modality and demonstrates its efficacity in difficult situations.


METHODS
From January 2003 until December 2005, 48 patients (age 30-89) were treated with VAC therapy for open abdomen, infected laparotomy wounds, or tissue loss due to debridement of Fournier's gangrene. Wound dressings were changed every 2-3 days.


RESULTS
Thirty-eight patients (79%) had major co-morbid conditions liable to impact negatively on wound healing. The treatment duration with VAC varied from 20-30 days with an average of eleven dressing changes (minimum 3-maximum 18). Treatment was effective in all patients. Spontaneous closure was achieved in 36 cases (75%); nine patients (19%) required a split-thickness skin graft, and three (6%) underwent delayed secondary closure.


CONCLUSIONS
In our institution, VAC has become the treatment of choice for complex abdominal and perineal wounds. It is a safe, simple, and effective technique to speed wound healing and it has reduced the duration of hospital treatment in difficult clinical situations and in patients whose general condition is often severely compromised.
Durmishi
Y
Y
Département de Chirurgie, Hôpital Universitaire de Genève, 24 Rue Micheli-du-Crest, Geneva, Switzerland. ymer.durmishi@hcuge.ch
Gervaz
P
P
Bühler
L
L
Bucher
P
P
Zufferey
G
G
Al-Mazrouei
A
A
Morel
Ph
P
D000005:Abdomen / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003646:Debridement; D005260:Female; D018934:Fournier Gangrene / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy; D009779:Occlusive Dressings; D010502:Perineum / Q000293:injuries / Q000601:surgery*; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000601:surgery; D013997:Time Factors; D014945:Wound Healing