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Open Access Research article

Negative pressure wound therapy management of the “open abdomen” following trauma: a prospective study and systematic review

Pradeep Navsaria1, Andrew Nicol1, Donald Hudson1, John Cockwill2 and Jennifer Smith3*

Author Affiliations

1 Department of Surgery, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa

2 Smith & Nephew, St Petersberg, Florida, USA

3 Smith & Nephew, 101 Hessle Road, Hull, HU3 2BN, UK

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World Journal of Emergency Surgery 2013, 8:4  doi:10.1186/1749-7922-8-4

Published: 10 January 2013

Abstract

Introduction

The use of Negative Pressure Wound Therapy (NPWT) for temporary abdominal closure of open abdomen (OA) wounds is widely accepted. Published outcomes vary according to the specific nature and the aetiology that resulted in an OA. The aim of this study was to evaluate the effectiveness of a new NPWT system specifically used OA resulting from abdominal trauma.

Methods

A prospective study on trauma patients requiring temporary abdominal closure (TAC) with grade 1or 2 OA was carried out. All patients were treated with NPWT (RENASYS AB Smith & Nephew) to achieve TAC. The primary outcome measure was time taken to achieve fascial closure and secondary outcomes were complications and mortality.

Results

A total of 20 patients were included. Thirteen patients (65%) achieved fascial closure following a median treatment period of 3 days. Four patients (20%) died of causes unrelated to NPWT. Complications included fistula formation in one patient (5%) with spontaneous resolution during NPWT), bowel necrosis in a single patient (5%) and three cases of infection (15%). No fistulae were present at the end of NPWT.

Conclusion

This new NPWT kit is safe and effective and results in a high rate of fascial closure and low complication rates in the severely injured trauma patient.

Keywords:
Negative Pressure Wound Therapy (NPWT); Grade 1 and 2 open abdomen; Abdominal trauma; Fascial closure