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Gastroenterology Research and Practice
Volume 2014, Article ID 245182, 7 pages
http://dx.doi.org/10.1155/2014/245182
Clinical Study

VAWCM-Instillation Improves Delayed Primary Fascial Closure of Open Septic Abdomen

1Department of General Surgery, Affiliated Zhongda Hospital, Southeast University Medical School, 87 Dingjiaqiao, Nanjing, Jiangsu 210089, China
2Research Institute of General Surgery, Jinling Hospital, Nanjing University Medical School, 305 East Zhongshan Road, Nanjing, Jiangsu 210093, China
3Department of Surgery, Haian People’s Hospital, Nantong University Medical School, 17 Zhongba Road, Nantong, Jiangsu 226600, China

Received 24 August 2014; Accepted 18 November 2014; Published 7 December 2014

Academic Editor: Antoni Castells

Copyright © 2014 Qingsong Tao et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Failure to achieve delayed primary fascial closure (DPFC) is one of the main complications of open abdomen (OA), certainly when abdominal sepsis is present. This retrospective cohort study aims to evaluate the effect of combined therapy of vacuum-assisted mesh-mediated fascial traction and topical instillation (VAWCM-instillation) on DPFC in the open septic abdomen. Methods. The patients with abdominal sepsis who underwent OA using VAWCM were included and divided into the instillation and noninstillation (control) groups. The DPFC rate and other outcomes were compared between the two groups. Results. Between 2007 and 2013, 73 patients with open septic abdomen were treated with VAWCM-instillation and 61 cases with VAWCM-only. The DPFC rate in the instillation group was significantly increased (63% versus 41%, ). The mortality with OA was similar (24.6% versus 23%, ) between the two groups. However, time to DPFC and length of stay in hospital of the survivals were significantly decreased in the instillation group. In addition, VAWCM-instillation (OR 1.453, 95% CI 1.222–4.927, ) was an independent influencing factor related to successful DPFC. Conclusions. VAWCM-instillation could improve the DPFC rate but could not decrease the mortality in the patients with open septic abdomen.