Enteroatmospheric fistulas in open abdomen in trauma associated with abdominal reintervention and VAC therapy

Open abdomen is an alternative for the management of trauma patient, and negative pressure therapy of the wound using VAC^® device is a genuine sort of treatment. Although the device poses technical advantages, risks are present and a critical complication is the enteroatmospheric fistula formation (EAF).

To analize the role of negative pressure therapy length and VAC^® device number of changes on the EAF formation in trauma patients udergoing open abdomen.

Cut-off points were calculated using receiver operational characteristics curve. Values were compared with Student's t or Mann-Withney U tests, considering statistically significant p < 0.05.

EAF were present in 39 cases (5.9%). A significant difference in the presence of EAF was present in patients with negative pressure therapy of the wound length ≥ 11.2 days (46.9 vs. 1.3%; relative risk [RR]: 3.67; 95% confidence interval [95% IC]: 2.4-6.68; p = 0.017) and when ≥ 2.6 VAC^® device changes were performed (34.6 vs. 0.5%; RR: 6.92; 95% IC: 1.1-4.3; p < 0.001).

At our institution, the practice of >3 VAC^® device changes and length of therapy > 11 days should be carefully considered leading to reduce the risk of EAF formation.