[Treatment of open abdomen in patients with abdominal sepsis using the vacuum pack system]

In abdominal sepsis, when the initial surgery fails to control infection, a good choice may be to leave the abdomen open. This is a descriptive study of a series of cases using the vacuum pack system for temporary abdominal closure.

We studied 19 patients. Demographic data were obtained, as well as those related to the vacuum pack, and the final fascial closure. We describe the technique of temporary abdominal closure. Values are presented as mean ± standard deviation (SD).

The average length of the hospital stay was 24.7 days. Fourteen (73.7%) patients survived and five patients (26.3%) died. The mean treatment time with the vacuum pack was 12.7 days, with an average of 3.9 changes. Early fascial closing was achieved in seven patients with an average of 14.6 days. In seven patients a planned ventral hernia formed, which was repaired by separation of components on an average of 261 days or by polypropylene mesh on an average of 228 days.

In our series, early fascial closing was achieved using the vacuum pack at a lower frequency than reported by other authors. Other parameters analyzed were similar to those reported in the literature. The vacuum pack system demonstrated to be effective, although the final selection for temporary abdominal closure will depend on the experience of the institution as well as surgeon preference. The vacuum pack system for temporary abdominal closure of the open abdomen is an effective alternative in patients with abdominal sepsis.