Subscribe to RSS
DOI: 10.1055/s-0036-1598010
Temporary Vacuum-Assisted Closure of the Open Abdomen in Neonates
Publication History
24 August 2016
23 November 2016
Publication Date:
18 January 2017 (online)
![](https://www.thieme-connect.de/media/ejps/201705/lookinside/thumbnails/10-1055-s-0036-1598010_163852oa-1.jpg)
Abstract
Introduction The need for open abdomen in the treatment of severely ill neonates will increase in time as more complex abdominal procedures are undertaken. However, the experience of temporary closure of an open abdomen using vacuum-assisted closure (VAC) system is still relatively limited in premature and term neonates. The aim of this study is to describe and review our experience in the use of temporary VAC of the open abdomen for neonates with varying pathological processes.
Materials and Methods A retrospective folder review of all neonates treated with VAC for open abdomen over the study period of 2010 to 2014 at our institution was performed.
Results A total of 15 neonates were included in this study. Mean gestational age and postbirth age at VAC application were 33.6 ± 4.1 (28–40) weeks and 14 ± 10.2 (2–30) days, respectively. Mean weight at VAC application was 1,797.7 ± 730.8 (960–3,200) g. Initial diagnoses were necrotizing enterocolitis (seven), intestinal perforation (three), gastroschisis (two), congenital diaphragmatic hernia (two), and primary abdominal compartment syndrome (ACS) (one). Reasons for VAC application included confirmed ACS (2) and application to prevent ACS (13). Duration of VAC use was 4 ± 3.4 (0–13) days during which 2 ± 1.2 (1–5) applications were performed. Overall survival rate was 80% (12 of 15 patients). One patient with primary ACS died from sepsis with an open abdomen. The only potential VAC-related complication was an enterocutaneous fistula.
Conclusion Temporary VAC of the open abdomen is a safe method of temporary abdominal closure to prevent ACS in high-risk postoperative conditions in neonates of any gestational age and birth weight.
Keywords
vacuum-assisted closure - open abdomen - neonate - temporary abdominal closure - abdominal compartment syndromeNote
All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of retrospective study, formal consent is not required.
-
References
- 1 Hunt L, Frost SA, Hillman K, Newton PJ, Davidson PM. Management of intra-abdominal hypertension and abdominal compartment syndrome: a review. J Trauma Manag Outcomes 2014; 8 (01) 2
- 2 Sea S, Meckmongkol T, Moront ML. , et al. Vacuum-assisted closure: a novel method of managing surgical necrotizing enterocolitis. Eur J Pediatr Surg 2015; 25 (01) 41-45
- 3 Hassan SF, Pimpalwar A. Primary suture-less closure of gastroschisis using negative pressure dressing (wound vacuum). Eur J Pediatr Surg 2011; 21 (05) 287-291
- 4 Fenton SJ, Dodgion CM, Meyers RL, Nichol PF, Scaife ER. Temporary abdominal vacuum-packing closure in the neonatal intensive care unit. J Pediatr Surg 2007; 42 (06) 957-960 , discussion 960–961
- 5 Carlotti AP, Carvalho WB. Abdominal compartment syndrome: a review. Pediatr Crit Care Med 2009; 10 (01) 115-120
- 6 Divarci E, Karapinar B, Yalaz M. , et al. Incidence and prognosis of intraabdominal hypertension and abdominal compartment syndrome in children. J Pediatr Surg 2016; 51 (03) 503-507
- 7 Schierz IA, Giuffrè M, Piro E. , et al. Predictive factors of abdominal compartment syndrome in neonatal age. Am J Perinatol 2014; 31 (01) 49-54
- 8 Baharestani MM. Use of negative pressure wound therapy in the treatment of neonatal and pediatric wounds: a retrospective examination of clinical outcomes. Ostomy Wound Manage 2007; 53 (06) 75-85
- 9 van As AB, Navsaria P, Numanoglu A. , et al. Modified sandwich vacuum pack technique for temporary closure of abdominal wounds: an African perspective. Acta Clin Belg 2007; 62 (Suppl. 01) 215-219
- 10 Rentea RM, Somers KK, Cassidy L, Enters J, Arca MJ. Negative pressure wound therapy in infants and children: a single-institution experience. J Surg Res 2013; 184 (01) 658-664
- 11 Stoffan AP, Ricca R, Lien C, Quigley S, Linden BC. Use of negative pressure wound therapy for abdominal wounds in neonates and infants. J Pediatr Surg 2012; 47 (08) 1555-1559
- 12 Gutierrez IM, Gollin G. Negative pressure wound therapy for children with an open abdomen. Langenbecks Arch Surg 2012; 397 (08) 1353-1357
- 13 Gabriel A, Heinrich C, Shores J. , et al. Outcomes of vacuum-assisted closure for the treatment of wounds in a paediatric population: case series of 58 patients. J Plast Reconstr Aesthet Surg 2009; 62 (11) 1428-1436
- 14 Lopez G, Clifton-Koeppel R, Emil S. Vacuum-assisted closure for complicated neonatal abdominal wounds. J Pediatr Surg 2008; 43 (12) 2202-2207
- 15 McCord SS, Naik-Mathuria BJ, Murphy KM. , et al. Negative pressure therapy is effective to manage a variety of wounds in infants and children. Wound Repair Regen 2007; 15 (03) 296-301
- 16 Caniano DA, Ruth B, Teich S. Wound management with vacuum-assisted closure: experience in 51 pediatric patients. J Pediatr Surg 2005; 40 (01) 128-132
- 17 Vaughan WG, Grosfeld JL, West K, Scherer III LR, Villamizar E, Rescorla FJ. Avoidance of stomas and delayed anastomosis for bowel necrosis: the ‘clip and drop-back’ technique. J Pediatr Surg 1996; 31 (04) 542-545
- 18 Morykwas MJ, Argenta LC, Shelton-Brown EI, McGuirt W. Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Ann Plast Surg 1997; 38 (06) 553-562
- 19 [Anonymous]. Principles of Best Practice: Vacuum Assisted Closure in Paediatrics and Young People: A Consensus Document. London: MEP Ltd; 2009