Time to Terminate Vacuum-assisted Closure and Convert to Primary Abdominal Closure in Intra-abdominal Sepsis

Abstract

Introduction:There is no widely accepted surgical technique in intra-abdominal sepsis and there is also limited data on available surgical techniques and their outcomes. There is no significant difference between these techniques. The aim of the laparotomy, which is performed to control the source of sepsis, is to reduce mortality. This retrospective study was performed to investigate daily analysis of the effects of vacuum-assisted closure (VAC) on intra-abdominal inflammation, sepsis and mortality.Methods:The study included 159 patients who underwent VAC technique between January 2010 and April 2017. Statistical analysis of the effects of VAC technique was performed on a daily basis using APACHE IV score, Mannheim peritonitis index (MPI) and Sepsis-Related Organ Failure Assessment (SOFA) score.Results:VAC changes had a significant effect on APACHE IV score, MPI and SOFA score (p=0.0001). Although there was no significant difference in the SOFA scores between the 1st and 2nd changes or between the 3rd and 4th changes, there was a decrease in values over time.Conclusion:In the treatment of abdominal contamination with sepsis, VAC use had a positive effect on contamination by decreasing the predicted mortality rate on a daily basis. Although it had a positive effect on sepsis, the effect of VAC on sepsis alone was not significant.

Keywords

• vacuum-assisted closure
• intra-abdominal sepsis
• controlled exploration
• treatment