Vacuum-Assisted Abdominal Closure Is Safe and Effective: A Cohort Study in 74 Consecutive Patients

الملخص EN

Background.

Vacuum-assisted closure (VAC) has, in many instances, become the treatment of choice in patients with abdominal catastrophes.

This study describes the use and outcome of ABThera KCI® VAC in the Region Southern Denmark covering a population of approximately 1.202 mill inhabitants.

Method.

A prospective multicenter study including all patients treated with VAC during an eleven-month period.

Results.

A total of 74 consecutive patients were included.

Median age was 64.4 (9–89) years, 64% were men, and median body mass index was 25 (17–42).

Duration of VAC treatment was median 4.5 (0–39) days with median 1 (0–16) dressing changes.

Seventy per cent of the patients attended the intensive care unit.

The 90-day mortality was 15%.

A secondary closure of the fascia was obtained in 84% of the surviving patients.

Only one patient developed an enteroatmospheric fistula.

Patients with secondary closure were less likely to develop large hernias and had better self-evaluated physical health score (p < 0,05).

No difference in mental health was found.

Conclusion.

The abdominal VAC treatment in patients with abdominal catastrophes is safe and with a relative low complication rate.

Whether it might be superior to conventional treatment with primary closure when possible has yet to be proven in a randomized study.