Vacuum-Assisted Closure of Postoperative Abdominal Wounds: A Prospective Study

Subramonia, Sriram; Pankhurst, Sarah; Rowlands, Brian J.; Lobo, Dileep N.
May 2009
World Journal of Surgery;May2009, Vol. 33 Issue 5, p931
Academic Journal
We aimed to study outcome in patients with an open abdomen in whom the abdominal vacuum-assisted closure system (V.A.C.® Therapy™) was used to provide temporary cover and achieve wound closure. All patients in whom V.A.C. Therapy was used to manage laparotomy wounds between February 2006 and May 2007 at a University Teaching Hospital were followed up prospectively until successful completion or stoppage of V.A.C. Therapy. Of the 51 consecutive patients (33 male), V.A.C. Therapy was used to manage a laparostomy in 10 patients and abdominal wound dehiscence in 41. Median (IQR) duration of V.A.C. Therapy was 17 (7–26) days. Wound healing was achieved in 31 (61%) patients, four of whom had additional surgery to assist wound closure. The rest healed by secondary intention. Treatment was withdrawn due to therapy-related complications in nine patients and due to medical or logistical reasons in seven. Four patients died while on therapy. While most V.A.C. Therapy-related problems were minor, two patients developed enteric fistulae that necessitated surgical repair. At a median (IQR) follow-up of 8 (4–13) months, 18 patients had stable cutaneous coverage with no incisional hernia, 12 developed an incisional hernia, 9 were lost to follow-up, and 12 died. V.A.C. Therapy is a useful adjunct in the management of the open abdomen and should be considered in the treatment of this problem. Restoration of cutaneous and fascial integrity of the abdominal wall, the risk of fistulisation, and the cost-effectiveness of this therapy require further evaluation.


Related Articles

  • Perforated obturator Littre hernia. Jacob, Tarun J.; Gaikwad, Pranay; Tirkey, Amit J.; Rajinikanth, Janakiraman; Raj, John P.; Muthusami, John C. // Canadian Journal of Surgery;Jun2009, Vol. 52 Issue 3, pE77 

    The article presents the case of a 75-year-old woman with acute abdomen along with Meckel diverticulum and obturator hernia. It describes the medical procedure in determining the specification of the disease including laparotomy, along with subsequent treatment. Considerations concerning the...

  • Acute abdomen after surgery. Spark, Ronald P. // Cortlandt Forum;4/25/96, Vol. 9 Issue 4, p146 

    Presents a case and analysis of an acute abdomen after surgery. Patient's diagnosis before surgery; Surgical procedure; Post-surgical complication.

  • EDITOR'S QUIZ: GI SNAPSHOT: Answer.  // Gut;Aug2004, Vol. 53 Issue 8, p1081 

    This article presents answer to a quiz related to a case of calcified caecal mass. At laparotomy, fundal cecectomy, including appendectomy, was performed. The peritoneum was normal. The specimen consisted of a 3x4x9 cm cystic appendiceal mass with the appearance of a "chicken drumstick," filled...

  • Adrenocortical Carcinoma Presenting with Signs of Acute Abdomen. Symeonidis, Dimitrios; Chatzinikolaou, Ioannis; Koukoulis, Georgios; Mamaloudis, Ioannis; Tepetes, Konstantinos // Case Reports in Surgery;2013, p1 

    Background. Adrenocortical carcinomas represent rare malignancies. In cases of hormone-secreting tumors, the hormone in excess determines the nearly diagnostic clinical presentation. Biologically inert tumors are diagnosed either due to the mass effect or incidentally. The purpose of the present...

  • Effect of Honey in Wound Repair in Patients Who Underwent Laparotomy. Askarpour, Shahnam; Rashidi, Iran; Daei, Sogand; Mahmoodi, Mozhgan // Internet Journal of Surgery;2010, Vol. 23 Issue 1, p1 

    Honey was already used a drug 5000 years ago. For centuries, honey has had a valuable state in medicine and it has been used for decreasing the risk of infection and improving ulcer healing. In recent years, there was a renaissance with a return to using honey as a drug in treatment of wounds,...

  • Standard abdominal wound edge protection with surgical dressings vs coverage with a sterile circular polyethylene drape for prevention of surgical site infections (BaFO): study protocol for a randomized controlled trial. Mihaljevic, Andr‚ L.; Michalski, Christoph W.; Erkan, Mert; Reiser-Erkan, Carolin; J„ger, Carsten; Schuster, Tibor; Schuhmacher, Christoph; Kleeff, J”rg; Friess, Helmut // Trials;2012, Vol. 13 Issue 1, p57 

    Background: Postoperative surgical site infections cause substantial morbidity, prolonged hospitalization, costs and even mortality and remain one of the most frequent surgical complications. Approximately 14% to 30% of all patients undergoing elective open abdominal surgery are affected and...

  • Primary Idiopathic Segmental Infarction of the Greater Omentum. Hedayati, Hossein; Sconzo, Frank T.; Yossundarakul, Chuladej; Bochetto Jr., Joseph F. // American Journal of Gastroenterology;Feb1971, Vol. 55 Issue 2, p168 

    Two cases of primary idiopathic segmental infarction of the greater omentum are presented. The preoperative findings simulated those of the acute surgical abdomen. Diagnosis was not entertained preoperatively, but made only at laparotomy. The etiology, pathogenesis, clinical findings and...

  • One Stop Management of Sigmoid Volvulus in an African Setting with Limited Resources. Achiek, M. M.; Tawad, F. K.; Alier, B. M.; Yur, C. T. // East & Central African Journal of Surgery;Mar/Apr2015, Vol. 20 Issue 1, p68 

    Objective: To show the feasibility and safety of emergency resection of an unprepared redundant sigmoid colon and primary anastomosis. Methods: A prospective study conducted at two Sudanese Hospitals, Nyala (Darfur) and Juba (South Sudan). Between January, 1st 2011 and December, 31st 2013,...

  • Primary omental torsion: Report of two cases. Matheos Efthimiou; Vasileios Kouritas; Fragkiskos Fafoulakis; Kostas Fotakakis; Kostas Chatzitheofilou // Surgery Today;Jan2009, Vol. 39 Issue 1, p64 

    Abstract  Two patients with omental torsion, who presented with acute abdomen, are reported. The first case, a 14-yearold boy, was admitted for acute appendicitis. During surgery, omental torsion on the long axis was diagnosed and the involved omentum was resected. The patient had not...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics