The open abdomen: temporary closure with a modified negative pressure therapy technique.
The most common indications for an open abdomen (OA) are abdominal compartment syndrome, damage control surgery, diffuse peritonitis and wound dehiscence, and often require a temporary abdominal closure (TAC). The different TAC methods that are currently available include skin closure techniques, mesh products and negative pressure therapy (NPT) systems. For this study, we retrospectively reviewed records of 115 OA patients treated with the commercially available NPT systems (V.A.C.(®) Abdominal Dressing System and ABThera™ Open Abdomen Negative Pressure Therapy System) using a new method of applying the system - the narrowing technique - over a 5-year period. Endpoints included fascial closure and 30-day mortality rates and presence of enteroatmospheric fistulas. Secondary closure of the fascia was obtained in 92% (106/115) of the patients with a mortality rate of 17% (20/115) and a fistula rate of 3·5% (4/115). The use of the narrowing technique to apply NPT may explain the high closure rates observed in the patient population of this study. Further studies are necessary to compare the different methods and to evaluate the long-term outcomes.
Surgical Department, University Hospital Odense, Odense, Denmark.
Helene T
HT
Hougaard
Mark
M
Ellebaek
Uffe T
UT
Holst
Niels
N
Qvist
D034841:Abdominal Cavity / Q000601:surgery*; D058107:Abdominal Wound Closure Techniques; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000517:prevention & control*; D016896:Treatment Outcome; D055815:Young Adult
Open abdomen; Temporary abdominal closure