Vacuum-Assisted Abdominal Closure Is Safe and Effective: A Cohort Study in 74 Consecutive Patients

Background. Vacuum-assisted closure (VAC) has, in many instances, become the treatment of choice in patients with abdominal catastrophes. This study describes the use and outcome of ABThera KCI VAC in the Region Southern Denmark covering a population of approximately 1.202 mill inhabitants. Method. A prospective multicenter study including all patients treated with VAC during an eleven-month period. Results. A total of 74 consecutive patients were included. Median age was 64.4 (9–89) years, 64% were men, and median body mass index was 25 (17–42). Duration of VAC treatment was median 4.5 (0–39) days with median 1 (0–16) dressing changes. Seventy per cent of the patients attended the intensive care unit.The 90-day mortality was 15%. A secondary closure of the fascia was obtained in 84% of the surviving patients. Only one patient developed an enteroatmospheric fistula. Patients with secondary closure were less likely to develop large hernias and had better self-evaluated physical health score (p < 0,05). No difference in mental health was found. Conclusion. The abdominal VAC treatment in patients with abdominal catastrophes is safe and with a relative low complication rate. Whether it might be superior to conventional treatment with primary closure when possible has yet to be proven in a randomized study.