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

BMC Surgery

Research Article

Giulia Montori¹  Roberto Manfredi¹  Federico Coccolini¹  Leonardo Solaini¹  Luca Campanati¹  Niccolò Allievi¹  Marco Ceresoli¹  Stefano Magnone¹  Paola Fugazzola¹  Matteo Tomasoni¹  Luca Ansaloni¹ 

[1] Unit of General Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24127, Bergamo, Italy;

关键词: Temporary abdominal closure;    Negative Pressure Wound Therapy;    Barker Vacuum Pack;    Open Abdomen;    Trauma;    Emergency surgery;   

DOI  :  10.1186/s12893-017-0281-3

 received in 2016-12-08, accepted in 2017-07-11,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundWe 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.MethodsIn 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.ResultsA 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.ConclusionsNPWT as a temporary abdominal closure technique, as compared to mBVP, appears to be associated with better outcomes in terms of mortality.

【 授权许可】

CC BY   
© The Author(s). 2017