Retrospective Study of Indications and Outcomes of Open Abdomen with Negative Pressure Wound Therapy Technique for Abdominal Sepsis in a Tertiary Referral Centre
Francesco Prete,
Giuseppe Massimiliano De Luca,
Alessandro Pasculli,
Giovanna Di Meo,
Elisabetta Poli,
Lucia Ilaria Sgaramella,
Piercarmine Panzera,
Francesco Vittore,
Antonella Filoia,
Fausto Catena,
Mario Testini,
Angela Gurrado
Affiliations
Francesco Prete
Academic General Surgery Unit, Department of Biomedical Sciences and Human Oncology, Medical School, University of Bari “Aldo Moro”, 70121 Bari, Italy
Giuseppe Massimiliano De Luca
Academic General Surgery Unit, Department of Biomedical Sciences and Human Oncology, Medical School, University of Bari “Aldo Moro”, 70121 Bari, Italy
Alessandro Pasculli
Academic General Surgery Unit, Department of Biomedical Sciences and Human Oncology, Medical School, University of Bari “Aldo Moro”, 70121 Bari, Italy
Giovanna Di Meo
Academic General Surgery Unit, Department of Biomedical Sciences and Human Oncology, Medical School, University of Bari “Aldo Moro”, 70121 Bari, Italy
Elisabetta Poli
Academic General Surgery Unit, Department of Biomedical Sciences and Human Oncology, Medical School, University of Bari “Aldo Moro”, 70121 Bari, Italy
Lucia Ilaria Sgaramella
Academic General Surgery Unit, Department of Biomedical Sciences and Human Oncology, Medical School, University of Bari “Aldo Moro”, 70121 Bari, Italy
Piercarmine Panzera
Academic General Surgery Unit, Department of Biomedical Sciences and Human Oncology, Medical School, University of Bari “Aldo Moro”, 70121 Bari, Italy
Francesco Vittore
Academic General Surgery Unit, Department of Biomedical Sciences and Human Oncology, Medical School, University of Bari “Aldo Moro”, 70121 Bari, Italy
Antonella Filoia
Academic General Surgery Unit, Department of Biomedical Sciences and Human Oncology, Medical School, University of Bari “Aldo Moro”, 70121 Bari, Italy
Fausto Catena
Emergency and Trauma Surgery Department, Maggiore Hospital of Parma, 43126 Parma, Italy
Mario Testini
Academic General Surgery Unit, Department of Biomedical Sciences and Human Oncology, Medical School, University of Bari “Aldo Moro”, 70121 Bari, Italy
Angela Gurrado
Academic General Surgery Unit, Department of Biomedical Sciences and Human Oncology, Medical School, University of Bari “Aldo Moro”, 70121 Bari, Italy
In patients with advanced sepsis from abdominal disease, the open abdomen (OA) technique as part of a damage control surgery (DCS) approach enables relook surgery to control infection, defer intestinal anastomosis, and prevent intra-abdominal hypertension. Limited evidence is available on key outcomes, such as mortality and rate of definitive fascial closure (DFC), which are needed for surgeons to select patients and adequate therapeutic strategies. Abdominal closure with negative pressure wound therapy (NPWT) has shown rates of DFC around 90%. We conducted a retrospective study to evaluate in-hospital survival and factors associated with mortality in acute, non-trauma patients treated using the OA technique and NPWT for sepsis from abdominal disease. Fifty consecutive patients treated using the OA technique and NPWT between February 2015 and July 2022 were included. Overall mortality was 32%. Among surviving patients, 97.7% of cases reached DFC, and the overall complication rate was 58.8%, with one case of entero-atmospheric fistula. At univariable analysis, age (p = 0.009), ASA IV status ( 30 (p = 0.001) and APACHE II score (p p = 0.029). Although very resource-intensive, DCS and the OA technique are valuable tools to manage patients with advanced abdominal sepsis, allowing reduced mortality and high DFC rates.
