BACKGROUND/ PURPOSE: Recent studies advocate the use of the open-abdomen technique for managing the abdominal compartment syndrome and uncontrolled intraperitoneal sepsis. The authors have used vacuum packing (Vac-Pac) in pediatric patients with excellent results and have developed a method for closing widely distracted fascial edges to avoid the need for skin grafting. METHODS: Patients who had an intraabdominal catastrophe best managed by a temporary open-abdomen technique were included. After damage control laparotomy, the Vac-Pac temporary closure was used. In 2 patients a corsetlike lacing was used to bring the widely separated fascial edges together gradually. RESULTS: Five patients with intraabdominal sepsis and one with the abdominal compartment syndrome were included. The length of time the Vac-Pac was used ranged from 3 to 21 days. In 2 patients, the corset closure allowed wound approximation within 5 to 7 days. One patient died of overwhelming sepsis, the remainder of the patients survived. CONCLUSIONS: The Vac-Pac technique for abdominal closure is a simple and inexpensive means by which to manage the open abdomen in the pediatric patient effectively. Use of a corset-type closure for wounds with widely distracted edges should eliminate the need for skin grafting over an open abdomen. Copyright 2002 by W.B. Saunders Company.
BACKGROUND/ PURPOSE: Recent studies advocate the use of the open-abdomen technique for managing the abdominal compartment syndrome and uncontrolled intraperitoneal sepsis. The authors have used vacuum packing (Vac-Pac) in pediatric patients with excellent results and have developed a method for closing widely distracted fascial edges to avoid the need for skin grafting. METHODS:Patients who had an intraabdominal catastrophe best managed by a temporary open-abdomen technique were included. After damage control laparotomy, the Vac-Pac temporary closure was used. In 2 patients a corsetlike lacing was used to bring the widely separated fascial edges together gradually. RESULTS: Five patients with intraabdominal sepsis and one with the abdominal compartment syndrome were included. The length of time the Vac-Pac was used ranged from 3 to 21 days. In 2 patients, the corset closure allowed wound approximation within 5 to 7 days. One patient died of overwhelming sepsis, the remainder of the patients survived. CONCLUSIONS: The Vac-Pac technique for abdominal closure is a simple and inexpensive means by which to manage the open abdomen in the pediatric patient effectively. Use of a corset-type closure for wounds with widely distracted edges should eliminate the need for skin grafting over an open abdomen. Copyright 2002 by W.B. Saunders Company.
Authors: Estas Bovill; Paul E Banwell; Luc Teot; Elof Eriksson; Colin Song; Jim Mahoney; Ronny Gustafsson; Raymund Horch; Anand Deva; Ian Whitworth Journal: Int Wound J Date: 2008-09-19 Impact factor: 3.315