Vacuum-Assisted Fascial Closure for Patients With Abdominal Trauma

Abstract

Patients requiring temporary abdominal closure have a significant in-hospital mortality rate of 33%. Delayed primary closure with vacuum assistance was achieved for 71.9% of the surviving patients. Maintaining a negative or total positive fluid balance of less than 20 L before the last attempted fascial closure improves successful closure rates, as seen in 19 of 22 patients (86.4%). The vacuum-assisted closure technique also enabled successful primary closure for two patients with extreme delay (>8 days). Elevated serum lactate levels are significantly correlated with early and in-hospital mortality. A significant decrease in lactate level during the first 12 hours is associated with achievement of primary closure.

Enteroatmospheric fistulas - the challenge of the open abdomen

“…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.…”

Manejo Del Abdomen Abierto: Desde La Operación Inicial Al Cierre Definitivo

“…Si bien el packing para el control del sangrado severo en el traumatismo hepático (Pringle) y en otras lesiones abdominales (Halsed) se conocen desde los años 1900 y 1912, respectivamente, el desarrollo y la difusión de la cirugía de control del daño se producen hacia finales de la década del 80 gracias a Stone en Atlanta y, principios de los 90, a Bruch en Houston 17 . Aunque la adaptación del término "control de daño" al campo del trauma puede ser acreditado a Schwab y cols.…”

“…(1983) cuando se llega a esta instancia "ya es tarde" 17 . Evitar la hipotermia, compensar el medio interno (acidosis metabólica) y seguir reponiendo la volemia son los aspectos para componer desde el momento del trauma, hasta su ingreso en la sala de emergencias.…”

Use of chorioamniotic membrane instead of bogota bag in open abdomen: How I Do It?

“…After that, the deliberately created ventral hernia is repaired 6-12 mo later. The above situation has been changed considerably with the introduction of vacuum application and biological prosthetic material [1][2][3][4][5] . Until recently, the practice was to discharge patients with an open fascia and partially closed skin.…”

“…It is reported that by using vacuum methods, fascial defects are reduced sufficiently to be closed [1][2][3][4] . It is also reported that in cases where closure is inadequate, by using acellular dermis, patients can be sent home without a fascial defect [5] .…”