INTRODUCTION: We analyse our experience and the results obtained with the use of vacuum assisted closure (VAC(®), KCI Clinic Spain SL) in the management of open abdomen. MATERIAL AND METHODS: We retrospectively reviewed the laparostomies performed between June 2006 and March 2011 using VAC(®) treatment in the Hospital Xeral-Cíes, Vigo. RESULTS: We included 23 consecutive patients (18 males and 5 females) on whom the VAC(®) was used in the open abdomen due to different indications (abdominal trauma, peritonitis, pancreatitis, ischaemic disease or abdominal compartmental syndrome). The VAC(®) needed changing a mean of 3.1 times per patient (range 1-7), with total mean treatment duration of 14.8 days (2-43) until closure, primary closure being achieved in 18 out of 21 patients (86%). The mean hospital stay was 110.1 days (8-163) and 6 patients (26%) died during their hospital stay due to problems related to their underlying disease. Seven cases (30%) had complications during the VAC® therapy: 3 intra-abdominal abscesses (13%), 4 fistulas or suture dehiscence (17%), and 1 evisceration (4%). CONCLUSIONS: VAC(®) therapy is simple to manage, with an acceptable rate of complication, particularly of intestinal fistulas, and a reduced mortality. Of the various systems available for the deferred closure of the abdomen, the VAC(®) has made considerable progress in the past few years, mainly due to its adaptable material, and its numerous advantages. Its use will possibly increase in the future.
INTRODUCTION: We analyse our experience and the results obtained with the use of vacuum assisted closure (VAC(®), KCI Clinic Spain SL) in the management of open abdomen. MATERIAL AND METHODS: We retrospectively reviewed the laparostomies performed between June 2006 and March 2011 using VAC(®) treatment in the Hospital Xeral-Cíes, Vigo. RESULTS: We included 23 consecutive patients (18 males and 5 females) on whom the VAC(®) was used in the open abdomen due to different indications (abdominal trauma, peritonitis, pancreatitis, ischaemic disease or abdominal compartmental syndrome). The VAC(®) needed changing a mean of 3.1 times per patient (range 1-7), with total mean treatment duration of 14.8 days (2-43) until closure, primary closure being achieved in 18 out of 21 patients (86%). The mean hospital stay was 110.1 days (8-163) and 6 patients (26%) died during their hospital stay due to problems related to their underlying disease. Seven cases (30%) had complications during the VAC® therapy: 3 intra-abdominal abscesses (13%), 4 fistulas or suture dehiscence (17%), and 1 evisceration (4%). CONCLUSIONS: VAC(®) therapy is simple to manage, with an acceptable rate of complication, particularly of intestinal fistulas, and a reduced mortality. Of the various systems available for the deferred closure of the abdomen, the VAC(®) has made considerable progress in the past few years, mainly due to its adaptable material, and its numerous advantages. Its use will possibly increase in the future.
Authors: M López-Cano; J M García-Alamino; S A Antoniou; D Bennet; U A Dietz; F Ferreira; R H Fortelny; P Hernandez-Granados; M Miserez; A Montgomery; S Morales-Conde; F Muysoms; J A Pereira; R Schwab; N Slater; A Vanlander; G H Van Ramshorst; F Berrevoet Journal: Hernia Date: 2018-09-03 Impact factor: 4.739
Authors: Ulrich Wirth; Bernhard W Renz; Dorian Andrade; Tobias S Schiergens; Helmut Arbogast; Joachim Andrassy; Jens Werner Journal: Int Wound J Date: 2018-03-30 Impact factor: 3.315
Authors: Federico Coccolini; Giulia Montori; Marco Ceresoli; Fausto Catena; Ernest E Moore; Rao Ivatury; Walter Biffl; Andrew Peitzman; Raul Coimbra; Sandro Rizoli; Yoram Kluger; Fikri M Abu-Zidan; Massimo Sartelli; Marc De Moya; George Velmahos; Gustavo Pereira Fraga; Bruno M Pereira; Ari Leppaniemi; Marja A Boermeester; Andrew W Kirkpatrick; Ron Maier; Miklosh Bala; Boris Sakakushev; Vladimir Khokha; Manu Malbrain; Vanni Agnoletti; Ignacio Martin-Loeches; Michael Sugrue; Salomone Di Saverio; Ewen Griffiths; Kjetil Soreide; John E Mazuski; Addison K May; Philippe Montravers; Rita Maria Melotti; Michele Pisano; Francesco Salvetti; Gianmariano Marchesi; Tino M Valetti; Thomas Scalea; Osvaldo Chiara; Jeffry L Kashuk; Luca Ansaloni Journal: World J Emerg Surg Date: 2017-08-14 Impact factor: 5.469