Alberto Federico Garcia (Cali / CO), Yaset Caicedo (Cali / CO), Fernando Rodriguez-Holguin (Cali / CO), Daniela Burbano (Manizales / CO), Isabella Caicedo-Holguin (Cali / CO), Carlos Gallego (Rochester, MN / US), Carlos Ordoñez (Cali / CO)
Abstract text (incl. references and figure legends)
Introduction: Negative pressure system (NPS) has been proposed as a tool for delayed abdominal closure in patients with severe trauma and hemodynamic instability. The potential benefits of NPS are prevention of abdominal compartment syndrome, control of contamination, wound healing, and bridge to definitive management. However, NPS has evolved from a self-made proposal like Barker"s vacuum pack to commercial systems. A gradual transition was made at our institution from self-made to commercial NPS between 2011 to 2017. This study aims to assess the clinical outcomes of trauma patients undergoing self-made or commercial NPS with delayed abdominal closure.
Methods: A retrospective, single-center study was performed in a high-complexity trauma center in Cali, Colombia. Trauma patients undergoing damage control surgery with delayed abdominal closure between 2011 and 2019 were included. Patients were classified according to the NPS: self-made (Wittman Patch or Barker"s Vacuum Pack) and commercial (VAC system of ABThera VAC System). Variables such as injury severity, time to definitive closure, complications, and mortality were analyzed.
Results: A total of 184 patients were included, 75 with self-made NPS and 109 with commercial NPS. Median of age was 29(IQR:23-41) years. Penetrating trauma was the most common mechanism in 85.9%(158/184). There was no difference between groups in injury severity [ISS median(IQR): Self-made 25(17-33) vs. Commercial 21(16-26)]. Time to definitive closure was 3(IQR:4-11) days, with no differences between groups (Log-rank test 0.439). The proportion of complications such as organic dysfunction, peritonitis, and intestinal fistula was not different. In-hospital mortality was 2.7%(5/184).
Conclusions: There is no difference between the self-made and commercial NPS for delayed abdominal closure in terms of time to definitive closure, complications, and mortality.
Disclosure: Do you have a significant financial interest, consultancy or other relationship with products, manufacturer(s) of products or providers of services related to this abstract? (If not, please enter "No" in the text field.)
No