Vacuum supported laparostomy--an effective treatment of intraabdominal infection

Notable experience using the vacuum assisted closure for abdominal wall defects was an assumption for its intra-abdominal application in severely septic patients with intra-abdominal infection. The goal of this study was to evaluate our experience with this new therapeutic technique.

This study is a retrospective analysis and comparison of two groups of patients with severe sepsis and proven intra-abdominal source of infection. Group A consisted of 41 patients, 31 men and 10 women with the age ranging 18-78 years old (mean 49.5), who were treated surgically between 1998 and 2002 using a combination of laparostomy, multiple irrigations and abdominal drainage. Group B consisted of 46 patients, 32 men and 14 women age 18-87 years old (mean 50.8), who were treated between 2002 and 2006 using former techniques with the addition of an intra-abdominal vacuum assisted negative pressure therapy system.

In the group A the number of re-laparotomies with debridement of the open abdominal wound in general anesthesia ranged from 5 to 18 over 10 to 35 days (mean 19.4) of hospital stay. In the group B, the number of re-laparotomies decreased to 3-9 and the hospital stay decreased to 7-29 days (mean 14.5). Fifteen patients (36.6%) in the group A died because of severe sepsis, compared to 11 patients (23.9%) in the group B.

Authors confirmed a significant reduction of morbidity and mortality using the intraabdominal vacuum assisted system in the treatment of localized intra-abdominal sepsis (Tab. 2, Ref 18). Full Text (Free, PDF) www.bmj.sk.