Vacuum-Assisted Fascial Closure for Patients With Abdominal Trauma

Abstract

Patients requiring temporary abdominal closure have a significant in-hospital mortality rate of 33%. Delayed primary closure with vacuum assistance was achieved for 71.9% of the surviving patients. Maintaining a negative or total positive fluid balance of less than 20 L before the last attempted fascial closure improves successful closure rates, as seen in 19 of 22 patients (86.4%). The vacuum-assisted closure technique also enabled successful primary closure for two patients with extreme delay (>8 days). Elevated serum lactate levels are significantly correlated with early and in-hospital mortality. A significant decrease in lactate level during the first 12 hours is associated with achievement of primary closure.