Vacuum-assisted wound closure provides early fascial reapproximation in trauma patients with open abdomens

Glen B. Garner, Drue N. Ware, Christine S Cocanour, James H. Duke, Bruce A. McKinley, Rosemary A. Kozar, Frederick A. Moore

Research output: Contribution to journalArticle

177 Scopus citations

Abstract

Background: Damage control and decompressive laparotomies salvage severely injured patients who would have previously died. Unfortunately, many of these patients develop open abdomens. A variety of management strategies exist. The end result in many cases, however, is a large ventral hernia that requires a complex repair 6 to 12 months after discharge. We instituted vacuum-assisted wound closure (VAWC) to achieve early fascial closure and eliminate the need for delayed procedures. Methods: For 12 months ending June 2000, 14 of 698 trauma intensive care unit admissions developed open abdomens and were managed with VAWC dressing. This was changed every 48 hours in the operating room with serial fascial approximation until complete closure. Results: Fascial closure was achieved in 13 patients (92%) in 9.9 ± 1.9 days, and 2.8 ± 0.6 VAWC dressing changes were performed. There were 2 wound infections, no eviscerations, and no enteric fistulas. Conclusions: Use of VAWC can safely achieve early fascial closure in more than 90% of trauma patients with open abdomens.

Original languageEnglish (US)
Pages (from-to)630-638
Number of pages9
JournalAmerican Journal of Surgery
Volume182
Issue number6
DOIs
StatePublished - 2001
Externally publishedYes

Keywords

  • Abdominal compartment syndrome
  • Abdominal trauma
  • Open abdomen
  • Vacuum closure

ASJC Scopus subject areas

  • Surgery

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