Open Abdomen Treatment with Dynamic Sutures and Topical Negative Pressure Resulting in a High Primary Fascia Closure Rate

World Journal of Surgery - Tập 36 Số 8 - Trang 1765-1771 - 2012
Reinhold Kafka-Ritsch1, Matthias Zitt1, Nina Schorn2, Sebastian Stroemmer1,2, Stefan Schneeberger1, Johann Pratschke1, Alexander Perathoner1
1Department of Visceral, Thorax and Transplant Surgery, University of Innsbruck, Innsbruck, Austria
2Medical University of Innsbruck, Innsbruck, Austria

Tóm tắt

AbstractBackgroundOpen abdomen (OA) treatment with negative‐pressure therapy is a novel treatment option for a variety of abdominal conditions. We here present a cohort of 160 consecutive OA patients treated with negative pressure and a modified adaptation technique for dynamic retention sutures.MethodsFrom May 2005 to October 2010, a total of 160 patients—58 women (36 %); median age 66 years (21–88 years); median Mannheim peritonitis index 25 (5–43) underwent emergent laparotomy for diverse abdominal conditions (abdominal sepsis 78 %, ischemia 16 %, other 6 %).ResultsHospital mortality was 21 % (13 % died during OA treatment); delayed primary fascia closure was 76 % in the intent‐to‐treat population and 87 % in surviving patients. Six patients required reoperation for abdominal abscess and five patients for anastomotic leakage; enteric fistulas were observed in five (3 %) patients. In a multivariate analysis, factors correlating significantly with high fascia closure rate were limited surgery at the emergency operation and a Björk index of 1 or 2; factors correlating significantly with low fascia closure rate were male sex and generalized peritonitis.ConclusionsWith the aid of initially placed dynamic retention sutures, OA treatment with negative pressure results in high rates of delayed primary fascia closure. OA therapy with the technical modifications described is thus considered a suitable treatment option in various abdominal emergencies.

Từ khóa


Tài liệu tham khảo

Brock WB, 1995, Temporary closure of open abdominal wounds: the vacuum pack, Am Surg, 61, 30

10.1097/01.sla.0000124291.09032.bf

10.1097/01.TA.0000100218.03754.6A

10.1097/CCM.0b013e3181ec5cbe

10.1007/s00268‐009‐9996‐3

10.1007/s00268‐008‐9867‐3

10.1097/TA.0b013e31817fa451

10.1002/bjs.1800730514

10.1002/bjs.5922

10.1186/1757‐7241‐17‐17

Mentula P, 2011, Non‐traumatic causes and the management of the open abdomen, Minerva Chir, 66, 153

10.1186/cc8193

10.1007/s00268‐011‐1203‐7

10.1007/s00384‐010‐0887‐8

10.1007/s00268‐007‐9222‐0

10.1007/s00268‐008‐9762‐y

10.1177/145749690709600408

10.1016/j.surg.2010.01.021

10.1007/s00268‐011‐1210‐8

10.1002/bjs.7383

10.1007/BF00680111

Ohmann C, 1997, Prognostic indices in peritonitis, Hepatogastroenterology, 44, 937

10.1308/003588409X12486167520993

10.1016/S1091‐255X(02)00051‐3

10.1007/s00268‐009‐0005‐7

VlugMS BartelsSA WindJet al (2011) Which fast track elements predict early recovery after colon cancer surgery?Colorectal Dis. doi:10.1111/j.1463‐1318.2011.02854.x

Thông tin
Thông tin xuất bản

World Journal of Surgery

Tập 36 Số 8

1765-1771

Thông tin tác giả