Montori G, Allievi N, Coccolini F, Solaini L, Campanati L, Ceresoli M, Fugazzola P, Manfredi R, Magnone S, Tomasoni M, Ansaloni L, et al.
BMC surgery. Date of publication 2017 Jul 21;volume 17(1):86.
1. BMC Surg. 2017 Jul 21;17(1):86. doi: 10.1186/s12893-017-0281-3.
Negative Pressure Wound Therapy versus modified Barker Vacuum Pack as temporary
abdominal closure technique for Open Abdomen management: a four-year experience.
Montori G(1), Allievi N(2), Coccolini F(1), Solaini L(1), Campanati L(1),
Ceresoli M(1), Fugazzola P(1), Manfredi R(1), Magnone S(1), Tomasoni M(1),
Ansaloni L(1).
Author information:
(1)Unit of General Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24127,
Bergamo, Italy.
(2)Unit of General Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24127,
Bergamo, Italy. niccolo.allievi@gmail.com.
BACKGROUND: We reviewed our experience with patients presenting with trauma and
peritonitis who underwent an open abdomen (OA) procedure, and compared outcomes
between Negative Pressure Wound Therapy (NPWT) and a modified Barker Vacuum Pack
(mBVP) technique.
METHODS: In this descriptive study, we retrospectively analyzed data regarding
all patients who underwent OA for intra-abdominal sepsis or abdominal trauma at
our Centre from January 2012 to December 2015. Demographic data, co-morbidities,
indications to surgery, intra-operative details and Björck classification grade
were considered. Outcomes included were: time to closure in days, fascial closure
rates, ICU and hospital stay, in-hospital and overall mortality, and
entero-atmospheric fistula rate.
RESULTS: A total of 83 cases were considered. Mean closure time was 6 days versus
6.5 days (p = 0.71) in NPWT and mBVP groups, respectively; the fascial closure
rate was 75.4% versus 93.8% (p = 0.10). At multivariate analysis, in-hospital and
overall mortality were significantly higher within the mBVP, as compared to NPWT
(OR 3.8, 95% CI 1.1 to 13.1, p = 0.02 - OR 4.2, 95% CI 1.2 to 14.1, p = 0.01).
Entero-atmospheric fistula rate was 2.6% in the two groups.
CONCLUSIONS: NPWT as a temporary abdominal closure technique, as compared to
mBVP, appears to be associated with better outcomes in terms of mortality.
DOI: 10.1186/s12893-017-0281-3
PMCID: PMC5521106
PMID: 28732537 [Indexed for MEDLINE]
