Document Detail


Fascia-to-fascia closure with abdominal topical negative pressure for severe abdominal infections: preliminary results in a department of general surgery and intensive care unit.
MedLine Citation:
PMID:  20969470     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Vacuum-assisted fascial closure (VAFC-KCI(®)) of an open abdomen is one of the latest methods.
METHODS: A prospective observational study was performed with medical records of nine patients who had been treated by abdominal VAFC-KCI(®) from March 2006 to October 2007 in the Department of Surgical Sciences, University of Insubria. The mean Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores were 22.62 and 10.62, respectively. All patients had abdominal compartment syndrome and a sepsis source that was difficult to control.
RESULTS: All patients survived. The mean duration of open abdomen was 22.7 days (range, 3-50 days). Primary fascial closure was possible in six patients (66%), with a closure rate of 100% when early control of the infectious source was possible (Group A) but only 40% in patients with difficult and delayed control of infection (Group B). The mean durations of open abdomen in the two groups were statistically different: 8.5 days for Group A vs. 34.2 days for Group B (p < 0.005; Student t-test).
CONCLUSIONS: In our brief experience, VAFC-KCI(®) seems to be associated with a high fascial closure rate. The complexity of the management of abdominal source control has a role in the success of primary fascial closure. The VAFC-KCI(®) system seems to contribute positively in fascia-to-fascia abdominal closure in cases of severe abdominal infection, in particular when early surgical source control is obtained.
Authors:
Pietro Padalino; Gianlorenzo Dionigi; Giulio Minoja; Giulio Carcano; Francesca Rovera; Luigi Boni; Renzo Dionigi
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgical infections     Volume:  11     ISSN:  1557-8674     ISO Abbreviation:  Surg Infect (Larchmt)     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-10-25     Completed Date:  2011-01-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815642     Medline TA:  Surg Infect (Larchmt)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  523-8     Citation Subset:  IM    
Affiliation:
Department of General Surgery, University of Milano, Monza, Italy. pietro.pad@tiscali.it
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MeSH Terms
Descriptor/Qualifier:
Abdomen / surgery*
Adult
Aged
Fascia / surgery*
General Surgery
Humans
Hydrostatic Pressure*
Intensive Care Units
Middle Aged
Prospective Studies
Sepsis / prevention & control
Survival Analysis
Treatment Outcome
Wound Closure Techniques*
Wound Healing

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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