Temporary abdominal closure in trauma surgery: a comparative cohort study between open abdomen techniques with
Yuri Thomé Machado Petrillo1, Gabrieli Flesch da Silva2, Vitor Steffens Bracht3
1Federal University of Rio Grande do Sul, Porto Alegre, Brazil. ypetrillo@hcpa.edu.br.
Background:
The use of negative pressure therapy (NPT) to maintain an open abdomen (OA) is a well-established practice in trauma surgery. The aim of this study was to compare two techniques for temporary closure of the OA using negative pressure therapy NPT with regard to the outcome of definitive closure of the abdominal wall, the incidence of complications and mortality.
Methodology:
Controlled retrospective cohort study with trauma patients submitted to NPT as a method of maintaining OA. The groups were divided into "Group B", referring to the use of NPT by Barker dressing, and "Group V", referring to the use of NPT by RENASYS™ AB abdominal dressing.
Results:
A total of 76 patients were analyzed (Group B, n = 48; Group V, n = 28), with mean age of 34 years, and 92% male. The groups were equivalent in their trauma severity scores. The overall rate of abdominal cavity closure was 38%, higher in Group V than in Group B (46%, n = 13 vs. 33%, n = 16, p = 0.374). The peritoneostomy outcome was significantly higher in group B (48%, n = 23 vs. 21%, n = 6, p = 0.028). Moderate negative correlation was observed between the duration of OA therapy and the rate of definitive closure of the abdominal cavity (ρ -0.637; p < 0.0001). Damage control surgery (DCS) and shorter duration of OA were identified as predictors of closure.
Conclusion:
OA with NPT by industrial abdominal dressing decreases the rate of peritoniostomy as abdominal wall outcome compared to Barker dressing.
