Neue Anwendung der V.A.C.®-Therapie in der Bauchhöhle bei offenem Abdomen

Labler, Ludwig; Keel, Marius; Trentz, O.

doi:10.1055/s-2004-822668

Cited by 6 publications

(2 citation statements)

References 21 publications

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“…Nineteen series described trauma patients only [5, 8, 9, 17, 18, 21–23, 29, 32, 36–40, 47, 51, 55], and an additional 16 series described trauma, vascular surgery, and general surgical patients [2, 11, 24–28, 33, 34, 43, 44, 48–50]. Eight series described peritonitis patients only [6, 7, 12, 19, 20, 35, 45, 54], and three described vascular patients only [16, 18, 42].…”

Section: Resultsmentioning

confidence: 99%

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Temporary Closure of the Open Abdomen: A Systematic Review on Delayed Primary Fascial Closure in Patients with an Open Abdomen

et al. 2008

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BackgroundThis study was designed to systematically review the literature to assess which temporary abdominal closure (TAC) technique is associated with the highest delayed primary fascial closure (FC) rate. In some cases of abdominal trauma or infection, edema or packing precludes fascial closure after laparotomy. This “open abdomen” must then be temporarily closed. However, the FC rate varies between techniques.MethodsThe Cochrane Register of Controlled Trials, MEDLINE, and EMBASE databases were searched until December 2007. References were checked for additional studies. Search criteria included (synonyms of) “open abdomen,” “fascial closure,” “vacuum,” “reapproximation,” and “ventral hernia.” Open abdomen was defined as “the inability to close the abdominal fascia after laparotomy.” Two reviewers independently extracted data from original articles by using a predefined checklist.ResultsThe search identified 154 abstracts of which 96 were considered relevant. No comparative studies were identified. After reading them, 51 articles, including 57 case series were included. The techniques described were vacuum-assisted closure (VAC; 8 series), vacuum pack (15 series), artificial burr (4 series), Mesh/sheet (16 series), zipper (7 series), silo (3 series), skin closure (2 series), dynamic retention sutures (DRS), and loose packing (1 series each). The highest FC rates were seen in the artificial burr (90%), DRS (85%), and VAC (60%). The lowest mortality rates were seen in the artificial burr (17%), VAC (18%), and DRS (23%).ConclusionsThese results suggest that the artificial burr and the VAC are associated with the highest FC rates and the lowest mortality rates.

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Section: Resultsmentioning

confidence: 99%

“…The VAC technique was applied in eight series (Table 3) [3, 24, 25, 34, 37, 41, 47, 48]. The vacuum pack has been described in 15 series (Table 3) [5, 18, 20–22, 28, 38, 40, 44, 46, 51, 53].…”

Section: Resultsmentioning

confidence: 99%

Temporary Closure of the Open Abdomen: A Systematic Review on Delayed Primary Fascial Closure in Patients with an Open Abdomen

et al. 2008

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Soft Tissue Management in Open Fractures of the Lower Leg: The Role of Vacuum Therapy

Rancan

Keel

2008

Eur J Trauma Emerg Surg

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The management of severe open fractures of the lower leg continues to challenge the treating surgeon. Major difficulties include high infection rates as well as adequate temporary soft tissue coverage. In the past, these injuries were commonly associated with loss of the extremity. Today, vacuum therapy provides not only safe temporary wound coverage but also conditioning of the soft tissues until definitive wound closure. Amongst other advantages, bacterial clearance and increased formation of granulation tissue are attributed to vacuum therapy, making it an extremely attractive tool in the field of wound healing. However, despite its clinical significance, which is underlined by a constantly increasing range of indications, there is a substantial lack of basic research and well-designed studies documenting the superiority of vacuum therapy compared to alternative wound dressings. Vacuum therapy has been approved as an adjunct in the treatment of severe open fractures of the lower leg, complementing repeated surgical debridement and soft tissue coverage by microvascular flaps, which are still crucial in the treatment of these limb-threatening injuries. Vacuum therapy has in general proven useful in the management of soft tissue injuries and, since it is generally well tolerated and has low complication rates, it is fast becoming the gold standard for temporary wound coverage in the treatment of severe open fractures of the lower leg.

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Wound conditioning by vacuum assisted closure (V.A.C.) in postoperative infections after dorsal spine surgery

et al. 2006

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The use of vacuum assisted closure (V.A.C.) therapy in postoperative infections after dorsal spinal surgery was studied retrospectively. Successful treatment was defined as a stable healed wound that showed no signs of acute or chronic infection. The treatment of the infected back wounds consisted of repeated debridement, irrigation and open wound treatment with temporary closure by V.A.C. The instrumentation was exchanged or removed if necessary. Fifteen patients with deep subfascial infections after posterior spinal surgery were treated. The implants were exchanged in seven cases, removed completely in five cases and left without changing in one case. In two cases spinal surgery consisted of laminectomy without instrumentation. In two cases only the wound defects were closed by muscle flap, the remaining ones were closed by delayed suturing. Antibiotic treatment was necessary in all cases. Follow up was possible in 14 patients. One patient showed a new infection after treatment. The study illustrates the usefulness of V.A.C. therapy as a new alternative management for wound conditioning of complex back wounds after deep subfascial infection.

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Neue Anwendung der V.A.C.®-Therapie in der Bauchhöhle bei offenem Abdomen

Abstract: Additional intra-abdominally positioned V.A.C. system with an own drainage system supports open abdomen therapy with the standard abdominal V.A.C. system and prevents dissemination of intra-abdominal infection.

Cited by 6 publications

References 21 publications

Temporary Closure of the Open Abdomen: A Systematic Review on Delayed Primary Fascial Closure in Patients with an Open Abdomen

Temporary Closure of the Open Abdomen: A Systematic Review on Delayed Primary Fascial Closure in Patients with an Open Abdomen

Soft Tissue Management in Open Fractures of the Lower Leg: The Role of Vacuum Therapy

Wound conditioning by vacuum assisted closure (V.A.C.) in postoperative infections after dorsal spine surgery

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