title: The effect of vacuum-assisted closure in bacterial clearance of the infected abdomen.
abstract: BACKGROUND
  Laparostomy with vacuum-assisted closure (VAC) plays an important role in improving survival in the presence of abdominal infection. We conducted a study of the qualitative changes in the bacterial flora of the peritoneal cavity in patients with severe abdominal infection treated with laparostomy and a VAC device.
  
  
  METHODS
  Thirty-nine patients with severe abdominal infection treated with abdominal opening and VAC were registered in a clinical study. When an incidence of 53.8% of hospital-acquired peritoneal infection (HAPI) was found in the study patient population, it was decided to divide the patients in two groups according to whether or not they developed a HAPI. The patients' outcomes were then analyzed.
  
  
  RESULTS
  The durations of abdominal opening (p=0.04), length of stay in the intensive care unit (ICU) (p=0.01), and of hospitalization (p=0.04) were significantly greater in patients with HAPI than in those without it, whereas mortality did not differ on the basis of these three variables.
  
  
  CONCLUSIONS
  Superinfection is common in laparostomy done with a VAC device for managing severe abdominal infection. The data in the present study show that VAC does not alter the quality of the bacterial burden in primary abdominal contamination, nor does it seem to prevent a high incidence of HAPI. However, VAC is as effective in reducing mortality among patients with HAPI as among those without it.
authors.affiliation: 1 Third Department of Surgery, Aristotle University of Thessaloniki , AHEPA University Hospital, Thessaloniki, Greece .
authors.forename: Ioannis
authors.initials: I
authors.lastname: Pliakos
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Michalopoulos
authors.forename: Theodossis S
authors.initials: TS
authors.lastname: Papavramidis
authors.forename: Stergiani
authors.initials: S
authors.lastname: Arampatzi
authors.forename: Eudoxia
authors.initials: E
authors.lastname: Diza-Mataftsi
authors.forename: Spiros
authors.initials: S
authors.lastname: Papavramidis
mesh_terms: D000328:Adult; D000368:Aged; D003428:Cross Infection / Q000382:microbiology; D006801:Humans; D015994:Incidence; D059413:Intraabdominal Infections / Q000382:microbiology* / Q000601:surgery*; D007813:Laparotomy; D007902:Length of Stay; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D011446:Prospective Studies