Prospective Evaluation of Vacuum-Assisted Closure in Abdominal Compartment Syndrome and Severe Abdominal Sepsis

Perez, Daniel; Wildi, Stefan; Demartines, Nicolas; Bramkamp, Matthias; Koehler, Christian; Clavien, Pierre‐Alain

doi:10.1016/j.jamcollsurg.2007.05.015

Cited by 159 publications

(131 citation statements)

References 29 publications

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“…Some studies have shown the efficiency of the use of VAC in wounds that were not caused by trauma 22,23 , results similar to those found in our study. Differences were found in the temporary abdominal closure indications: the Bogota bag was most appropriate in cases involving trauma, while VAC was more indicated in cases of abdominal sepsis, abdominal compartment syndrome and mesenteric ischemia.…”

Section: Discussion Discussion Discussion Discussionsupporting

confidence: 92%

Open abdomen management: single institution experience

Rodrigues

Novo

Arouca

et al. 2015

Rev. Col. Bras. Cir.

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. Today, despite advances in AA use with the development of vacuum therapy, the Bogota Stock Exchange (BB) is still widely used. In our institution and throughout Brazil, both techniques are used and the study's goal is to evaluate the morbidity and the result of the integrity of the abdominal wall after the use of both techniques. METHODS METHODS METHODS METHODS METHODSA retrospective study was conducted at HCFMUSP, identifying patients undergoing temporary abdominal closure (FAT) between January 2005 and December 2011. Data were collected through review of medical records. Data were compared in patients undergoing treatment with assisted closing the vacuum and the Bogota bag.Inclusion criteria were temporary abdominal closure indication survival and the definitive abdominal closure. FAT indications included: abdominal trauma, severe abdominal sepsis and ACS. Data collected included age, FAT indication, the number of procedures in the operating room and the primary fascial closure rate. In the postoperative period, one group of three surgeons followed all patients and performed all reoperations. As soon as possible, the aponeurosis of the edges were subjected to progressive approach with careful not to cause abdominal hypertension.The demographics of the two study groups (BB and VAC) were compared using the chi-square test of Pearson or Fisher's exact test for categorical variables and the Student t test for continuous variables. RESULTS RESULTS RESULTS RESULTS RESULTSDuring the study period, 59 patients require some kind of temporary abdominal closure (FAT), however, only 29 patients survived the final abdominal closure (52.5% mortality). One patient was excluded (subject to closure Backaus forceps). Thus, 28 patients were included, and, after two years of follow-up, none of them developed abdominal hernia or intestinal fistulas.There was no statistical difference between the study groups with respect to age (p> 0.05) and a significant difference regarding indications for temporary abdominal closure (p <0.05) ( Table 1).The primary closure rates were similar in both groups (p = 0.98). The average time (days) for fascial closure was 10.8 days for the BB group and 7.52 days in the group VAC (Table 2). DISCUSSION DISCUSSION DISCUSSION DISCUSSION DISCUSSIONIn this study, there was no statistical difference between the closing assisted vacuum and the Bogota bag (VAC and BB) when analyzed the number of operations, the primary closure, and the average time of closing. However, a previous study 19 showed better results when using VAC BB was compared on the primary closure (50 to 70 %% and 88% for BB VAC). The best approach to achieve the definitive abdominal closure in patients with open abdomen remains controversial. To improve the fascial closure rate, the excess volume resuscitation should be avoided, the water balance should be carefully implemented, not only on admission, but also throughout the course of treatment with open abdomen 20 . The high rate of primary closure found in our patients, 80% for BB and 96% f...

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Section: Discussion Discussion Discussion Discussionsupporting

confidence: 92%

Open abdomen management: single institution experience

Rodrigues

Novo

Arouca

et al. 2015

Rev. Col. Bras. Cir.

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“…The review of 18 series with overall 1395 patients managed by OA and V.A.C. revealed a mean rate of EAFs 6.1% (Table 2), (4,8,14,17,19,20,(26)(27)(28)(29)31,32,(36)(37)(38)42,45,47), which is comparable to 7.2% in our series.…”

Section: Discussionsupporting

confidence: 76%

Enteroatmospheric fistulas - the challenge of the open abdomen

Mutafchiyski

Popivanov

Kjossev

et al. 2015

SSM

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INTRODUCTION:In the past two decades, the open abdomen (OA) technique has gained wide popularity as an effective approach in the cases with severe peritonitis, abdominal compartment syndrome and critical trauma. However, it is still associated with high complication rate. Enteroatmospheric fistulas are the most devastating complication. Despite the numerous techniques described in the literature, their management remains a challenging task.

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“…In certain cases of severe peritonitis, the surgeon may feel that a further look is required to achieve these goals [1] . This can be achieved by leaving the abdomen open at the index operation [3] . While this concept of a planned second look following major abdominal trauma is well recognised [4] , its use following abdominal catastrophe due to severe peritonitis remains controversial [3] .…”

Section: Introductionmentioning

confidence: 99%

“…This can be achieved by leaving the abdomen open at the index operation [3] . While this concept of a planned second look following major abdominal trauma is well recognised [4] , its use following abdominal catastrophe due to severe peritonitis remains controversial [3] . Several different techniques have been tried to facilitate a second look [4][5][6] .…”

Section: Introductionmentioning

confidence: 99%