• 作者：Lucinda P¨¦rez Dom¨ªnguez ; Hermelinda Pardellas Rivera ; Nieves C¨¢ceres Alvarado ; ¨¢ngel L¨®pez Saco ; ¨¢ngel Rivo V¨¢zquez ; Enrique Casal N¨²?ez
• 关键词：Laparostomí ; a ; Abdomen abierto ; Vacuum assisted closure
• 刊名：Cirug¡§aa Espa?ola
• 出版年：2012
• 出版时间：October, 2012
• 年：2012
• 卷：90
• 期：8
• 页码：506-512
• 全文大小：951 K

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-C¨ªes, 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.