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Negative Pressure Wound Therapy versus modified Barker Vacuum Pack as temporary abdominal closure technique for Open Abdomen management: a four-year experience

Authors :
Giulia Montori
Niccolò Allievi
Federico Coccolini
Leonardo Solaini
Luca Campanati
Marco Ceresoli
Paola Fugazzola
Roberto Manfredi
Stefano Magnone
Matteo Tomasoni
Luca Ansaloni
Source :
BMC Surgery, Vol 17, Iss 1, Pp 1-6 (2017)
Publication Year :
2017
Publisher :
BMC, 2017.

Abstract

Abstract Background We reviewed our experience with patients presenting with trauma and peritonitis who underwent an open abdomen (OA) procedure, and compared outcomes between Negative Pressure Wound Therapy (NPWT) and a modified Barker Vacuum Pack (mBVP) technique. Methods In this descriptive study, we retrospectively analyzed data regarding all patients who underwent OA for intra-abdominal sepsis or abdominal trauma at our Centre from January 2012 to December 2015. Demographic data, co-morbidities, indications to surgery, intra-operative details and Björck classification grade were considered. Outcomes included were: time to closure in days, fascial closure rates, ICU and hospital stay, in-hospital and overall mortality, and entero-atmospheric fistula rate. Results A total of 83 cases were considered. Mean closure time was 6 days versus 6.5 days (p = 0.71) in NPWT and mBVP groups, respectively; the fascial closure rate was 75.4% versus 93.8% (p = 0.10). At multivariate analysis, in-hospital and overall mortality were significantly higher within the mBVP, as compared to NPWT (OR 3.8, 95% CI 1.1 to 13.1, p = 0.02 – OR 4.2, 95% CI 1.2 to 14.1, p = 0.01). Entero-atmospheric fistula rate was 2.6% in the two groups. Conclusions NPWT as a temporary abdominal closure technique, as compared to mBVP, appears to be associated with better outcomes in terms of mortality.

Details

Language :
English
ISSN :
14712482
Volume :
17
Issue :
1
Database :
Directory of Open Access Journals
Journal :
BMC Surgery
Publication Type :
Academic Journal
Accession number :
edsdoj.1c6a274b3c48f0890c6b7ee366b590
Document Type :
article
Full Text :
https://doi.org/10.1186/s12893-017-0281-3