title: VAC therapy with long term continuous saline infusion for secondary septic peritonitis: A new strategy for the reduction of perioperative risks?
abstract: BACKGROUND
  The management of a septic peritonitis open abdomen is a serious problem for clinicians. Open surgery is associated with several complications such as bleeding and perforation of the bowel.
  
  
  METHODS
  The authors report a case of a 59-years-old female who underwent a sigmoid resection with an latero-terminal (L-T) anastomosis for the perforation of a diverticulum. After a few days the patients developed a new widespread peritonitis. At the emergency re-laparotomy, surgeons found dehiscence of the posterior wall of the anastomosis with fecal contamination. At admission in ICU (Intensive Care Unit) the patient had open abdomen with dehiscence of cutaneous and subcutaneous layers.
  
  
  CONCLUSIONS
  Conservative therapy with antibiotic therapy and use of the Vacuum-Assisted Closure®(VAC) Therapy with a long term continuous saline infusion led to the resolution of the septic shock and to the wound healing.
authors.affiliation: Santa Maria della Misericordia Hospital, Anaesthesiology and Intensive Care Unit Department, Perugia, Italy. Electronic address: fulvio.nisi@gmail.com.
authors.forename: Fulvio
authors.initials: F
authors.lastname: Nisi
authors.affiliation: Santa Maria della Misericordia Hospital, Anaesthesiology and Intensive Care Unit Department, Perugia, Italy. Electronic address: federicomarturano@msn.com.
authors.forename: Federico
authors.initials: F
authors.lastname: Marturano
authors.affiliation: Santa Maria della Misericordia Hospital, Anaesthesiology and Intensive Care Unit Department, Perugia, Italy. Electronic address: eleonoranatali88@gmail.com.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Natali
authors.affiliation: Santa Maria della Misericordia Hospital, Anaesthesiology and Intensive Care Unit Department, Perugia, Italy. Electronic address: antoniogalzerano@libero.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Galzerano
authors.affiliation: Santa Maria della Misericordia Hospital, Surgical Department, Perugia, Italy. Electronic address: patrizia.ricci@unipg.it.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Ricci
authors.affiliation: Santa Maria della Misericordia Hospital, Anaesthesiology and Intensive Care Unit Department, Perugia, Italy. Electronic address: vito.peduto@unipg.it.
authors.forename: Vito Aldo
authors.initials: VA
authors.lastname: Peduto
keywords: Negative pressure therapy; Open abdomen; Septic peritonitis; VAC therapy