Abstract
Background Vacuum-assisted closure (VAC) has, in many instances, become the treatment of choice in patients with abdominal catastrophes. This study describes the use and outcome of ABThera KCI® VAC in the Region Southern Denmark covering a population of approximately 1.202 mill inhabitants. Method A prospective multicenter study including all patients treated with VAC during an eleven-month period. Results A total of 74 consecutive patients were included. Median age was 64.4 (9–89) years, 64% were men, and median body mass index was 25 (17–42). Duration of VAC treatment was median 4.5 (0–39) days with median 1 (0–16) dressing changes. Seventy per cent of the patients attended the intensive care unit. The 90-day mortality was 15%. A secondary closure of the fascia was obtained in 84% of the surviving patients. Only one patient developed an enteroatmospheric fistula. Patients with secondary closure were less likely to develop large hernias and had better self-evaluated physical health score (p < 0,05). No difference in mental health was found. Conclusion The abdominal VAC treatment in patients with abdominal catastrophes is safe and with a relative low complication rate. Whether it might be superior to conventional treatment with primary closure when possible has yet to be proven in a randomized study.
Highlights
Leaving the abdomen open after emergency laparotomy has gained increased popularity during recent decades
This study describes the use and outcome of ABThera KCI5 Vacuum-assisted closure (VAC) in the Region Southern Denmark covering a population of approximately 1.202 mill inhabitants
The method inherits a range of problems, such as management of the open abdomen, secondary closure of the fascia, the development of ventral hernias, and enteroatmospheric fistulas
Summary
Leaving the abdomen open after emergency laparotomy has gained increased popularity during recent decades. The method inherits a range of problems, such as management of the open abdomen, secondary closure of the fascia, the development of ventral hernias, and enteroatmospheric fistulas. One of the main outcomes of treatment with open abdomen is mortality, which has been reported to vary between 18 and 65% [3,4,5,6,7] dependent on patient selection. Another important outcome is the secondary closure of the fascia to prevent the development of symptomatic ventral hernias. Whether it might be superior to conventional treatment with primary closure when possible has yet to be proven in a randomized study
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