title: Intra-abdominal vacuum-assisted closure (VAC) after necrosectomy for acute necrotising pancreatitis: preliminary experience.
abstract: Infection of pancreatic necrosis, although present in less than 10% of acute pancreatitis, carries a high risk of mortality; debridment and drainage of necrosis is the treatment of choice, followed by 'open' or 'close' abdomen management. We recently introduced the use of intra-abdominal vacuum sealing after a classic necrosectomy and laparostomy. Two patients admitted to ICU for respiratory insufficiency and a diagnosis of severe acute pancreatitis developed pancreatic necrosis and were treated by necrosectomy, lesser sac marsupialisation and posterior lumbotomic opening. Both of the patients recovered from pancreatitis and a good healing of laparostomic wounds was obtained with the use of the VAC system. Most relevant advantages of this technique seem to be: the prevention of abdominal compartment syndrome, the simplified nursing of patients and the reduction of time to definitive abdominal closure.
authors: Emergency Surgery Unit, Department of Surgery, Policlinico Gemelli, Università Cattolica del Sacro Cuore, Roma, Italy. daniel.s@tiscali.it
authors: D
authors: D
authors: Sermoneta
authors: M
authors: M
authors: Di Mugno
authors: P L
authors: PL
authors: Spada
authors: C
authors: C
authors: Lodoli
authors: M E
authors: ME
authors: Carvelli
authors: S C
authors: SC
authors: Magalini
authors: C
authors: C
authors: Cavicchioni
authors: M G
authors: MG
authors: Bocci
authors: F
authors: F
authors: Martorelli
authors: M G
authors: MG
authors: Brizi
authors: D
authors: D
authors: Gui
mesh_terms: D034841:Abdominal Cavity; D000368:Aged; D003161:Compartment Syndromes / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000379:methods* / Q000451:nursing; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods; D019283:Pancreatitis, Acute Necrotizing / Q000175:diagnosis / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods* / Q000451:nursing; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014945:Wound Healing