Vacuum-Assisted Abdominal Closure Is Safe and Effective: A Cohort Study in 74 Consecutive Patients.

Surgery Research and Practice Pub Date : 2017-01-01 Epub Date: 2017-09-11 DOI:10.1155/2017/7845963

R O Jensen, T Buchbjerg, R M Simonsen, R Eckardt, N Qvist

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引用次数: 3

Abstract

Background: Vacuum-assisted closure (VAC) has, in many instances, become the treatment of choice in patients with abdominal catastrophes. This study describes the use and outcome of ABThera KCI® VAC in the Region Southern Denmark covering a population of approximately 1.202 mill inhabitants.

Method: A prospective multicenter study including all patients treated with VAC during an eleven-month period.

Results: A total of 74 consecutive patients were included. Median age was 64.4 (9-89) years, 64% were men, and median body mass index was 25 (17-42). Duration of VAC treatment was median 4.5 (0-39) days with median 1 (0-16) dressing changes. Seventy per cent of the patients attended the intensive care unit. The 90-day mortality was 15%. A secondary closure of the fascia was obtained in 84% of the surviving patients. Only one patient developed an enteroatmospheric fistula. Patients with secondary closure were less likely to develop large hernias and had better self-evaluated physical health score (p < 0,05). No difference in mental health was found.

Conclusion: The abdominal VAC treatment in patients with abdominal catastrophes is safe and with a relative low complication rate. Whether it might be superior to conventional treatment with primary closure when possible has yet to be proven in a randomized study.

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真空辅助腹部闭合安全有效:74例连续患者的队列研究。

背景:在许多情况下，真空辅助闭合(VAC)已成为腹部灾难患者的首选治疗方法。本研究描述了ABThera KCI®VAC在丹麦南部地区的使用情况和结果，该地区覆盖了大约1202万居民。方法:一项前瞻性多中心研究，包括所有在11个月期间接受VAC治疗的患者。结果:共纳入74例连续患者。中位年龄为64.4(9-89)岁，男性占64%，中位体重指数为25(17-42)。VAC治疗持续时间中位数为4.5(0-39)天，中位数为1(0-16)次换药。70%的病人在重症监护室接受治疗。90天死亡率为15%。在84%的存活患者中获得了二次筋膜闭合。仅有1例患者出现肠-大气瘘。二次缝合的患者发生大疝的可能性较小，自我评估的身体健康评分也较好(p < 0.05)。在心理健康方面没有发现差异。结论:腹腔腔灌洗术治疗腹部大病安全、并发症发生率低。在可能的情况下，它是否优于常规的初级闭合治疗还有待一项随机研究的证明。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery Research and Practice

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期刊介绍： Surgery Research and Practice is a peer-reviewed, Open Access journal that provides a forum for surgeons and the surgical research community. The journal publishes original research articles, review articles, and clinical studies focusing on clinical and laboratory research relevant to surgical practice and teaching, with an emphasis on findings directly affecting surgical management.