[Managing the open abdomen with vacuum-assisted closure therapy: retrospective evaluation of 22 patients]

J Chir (Paris). 2008 May-Jun;145(3):252-61. doi: 10.1016/s0021-7697(08)73755-4.
[Article in French]


Background: The authors reviewed their experience in the management of "open abdomen" using the vacuum-assisted closure device (VAC), in order to assess its morbidity particularly in terms of fistula, and the outcome of abdominal wall integrity.

Methods: Between January 2003 and October 2006, 22 patients required management with an "open abdomen" technique (18 patients were managed with the VAC abdominal dressing device with application of a specific sheet and 4 other patients simply required a dressing with the polyurethane sponge). The mean age was 55 years, and M/F sex ratio was 2.67. Indications were abdominal compartment syndrome in 7 patients, initial "abdominal closure" after trauma in one patient, severe abdominal sepsis in 7 patients, and abdominal wound dehiscence where closure was impossible in 7 patients.

Results: There were no enteric fistulae. Two infections were seen--a chronic suppuration which resolved with antibiotic therapy and a deep abscess which was drained with radiologic guidance. Of the 18 cases of "open abdomen" managed with the VAC, 15 were alive. Six (40%) underwent a delayed primary closure at a mean interval of 9 days; the others underwent secondary healing by granulation, and 10 eventually underwent split thickness skin grafting at a mean interval of 50 days. With VAC closure of the "open abdomen", the development of ventral hernia is an anticipated outcome; in four cases, patients underwent abdominal wall reconstruction at an interval of one year.

Conclusion: Laparostomy or "open abdomen" using the VAC dressing system should be considered an established and well-defined technique which provides temporary abdominal coverage with limited morbidity.

Publication types

  • English Abstract

MeSH terms

  • Abdominal Wall / surgery*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Decision Trees
  • Female
  • Humans
  • Male
  • Middle Aged
  • Negative-Pressure Wound Therapy*
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Young Adult