title: Are commercial negative pressure systems worth the cost in open abdomen management?
abstract: BACKGROUND
  A commercial negative pressure product is compared with the Barker technique (sterile x-ray cassette cover, lap pads, adhesive drape with negative pressure) for temporary abdominal closure in open abdomen management.
  
  
  METHODS
  We performed a retrospective review of 37 open abdomen patients who had temporary abdominal closure with a commercial negative pressure device (ABThera, KCI) from 2010 to 2011. These patients were compared with the most recent 37 patients having open abdomen management using the Barker technique from 2009 to 2010. Patient demographics, body mass index (BMI), preoperative albumin, indication for open abdomen management, number of operations, use of sequential closure, and success with closure were analyzed. Patients were compared using chi square, t-test, and logistic regression analysis with significance of p < 0.05.
  
  
  RESULTS
  Mean age and BMI were significantly higher in the ABThera patients. No statistically significant differences were seen in male:female ratio, indication for open abdomen management, preoperative albumin, number of operations, and use of sequential closure. In 33 patients (89%) ultimate midline fascial closure was achieved with the ABThera vs in 22 patients (59%) using the Barker technique (p < 0.05). Logistic regression analysis was performed on the 3 significant variables identified on bivariate analysis. Only the type of temporary abdominal closure proved significant, with an odds ratio of 7.97 favoring ABThera (95% CI 1.98 to 32.00).
  
  
  CONCLUSIONS
  A commercially available negative pressure device for temporary abdominal closure had significantly greater success with ultimate closure after open abdomen management compared with the Barker technique. The added cost of the device is offset by improved patient results and savings from successful closure.
authors: Division of Trauma and Acute Care Surgery, Texas A&M Health Science Center, Scott & White Healthcare, Temple, TX 75608, USA. Rfrazee@sw.org
authors: Richard C
authors: RC
authors: Frazee
authors: Stephen W
authors: SW
authors: Abernathy
authors: Daniel C
authors: DC
authors: Jupiter
authors: John C
authors: JC
authors: Hendricks
authors: Matthew
authors: M
authors: Davis
authors: Justin L
authors: JL
authors: Regner
authors: Travis
authors: T
authors: Isbell
authors: Randall W
authors: RW
authors: Smith
authors: W Roy
authors: WR
authors: Smythe
mesh_terms: D058107:Abdominal Wound Closure Techniques / Q000191:economics* / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000191:economics* / Q000295:instrumentation*; D012189:Retrospective Studies