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Negative pressure wound therapy for children with an open abdomen.
MedLine Citation:
PMID:  22382700     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: The utility of negative pressure wound therapy (NPWT) in the management of adults with an open abdomen has been well documented. We reviewed our experience with NPWT in the management of infants and children with this condition. METHODS: The records of all children who were treated with NPWT for an open abdomen between March 2005 and September 2009 at a single children's hospital were reviewed. RESULTS: Twenty-five subjects were identified. They included children who developed abdominal compartment syndrome after a laparotomy (n = 12) or in whom the abdomen could not be safely closed at the time of laparotomy (n = 13). NWPT was accomplished with the vacuum-assisted closure (VAC®) system in all patients. The median duration for NPWT was 4.5 days. In 16 subjects, the abdomen was closed successfully after NPWT. In 14 children, the abdominal wall fascia was successfully approximated, and two children underwent a patch abdominal closure. But nine subjects died before an abdominal closure could be attempted. Only two (12.5%) children developed enterocutaneous fistulae. CONCLUSIONS: NPWT is a reliable tool for infants and children with an open abdomen. Wound management was facilitated and abdominal wall closure was ultimately achieved in all survivors. Enterocutaneous fistulae developed in two children, however, these were likely due to underlying bowel injury and would have occurred despite variations in management of the open abdomen.
Authors:
Ivan M Gutierrez; Gerald Gollin
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-1
Journal Detail:
Title:  Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie     Volume:  -     ISSN:  1435-2451     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9808285     Medline TA:  Langenbecks Arch Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Division of Pediatric Surgery, Loma Linda University School of Medicine, 11175 Campus St., CP 21111, Loma Linda, CA, 92354, USA.
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