Jiang Jin-bo, Dai Yong, Zhu Min, Shou Nan-hai
Department of General Surgery, Qilu Hospital, Shandong University, Jinan 250012, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2006 Jan;9(1):50-2.
To investigate the clinical application of a new temporary abdominal wound closure,vacuum system for temporary management of the open abdomen.
Vacuum pack system consisted of polyethylene sheet,surgical towel,silicone drain, adhesive plastic drape. Clinical data of the patients undergoing exploratory celiotomy were recorded,and the indications for such temporary abdominal closure and its complications were reviewed.
Thirteen trauma patients underwent such vacuum abdominal closure for 15 times, including 5 times (33.3%) for increased intra- abdominal pressure so that tension-free fascial closure was unable to achieve, 4 times (26.7%) for reexploration, 2 times (13.3%) for damage control, and 4 times (26.7%) for combined factors. Finally, seven patients (53.8%) received direct closure and 5 patients (38.5%) received skin grafting after granulation because the defect could not be closed directly. One patient (7.7%) died before abdominal closure was attempted. None of the patients developed enterocutaneous fistula and evisceration. Three patients (23.1%) developed intra-abdominal abscess.
The vacuum pack is a better temporary abdominal wound closure device, and primary closure can be achieved in most of the patients. The technique is simple and easily mastered with a low complication rate.
探讨一种新型临时性腹部伤口封闭负压系统在开放性腹部临时处理中的临床应用。
负压包系统由聚乙烯片、手术巾、硅胶引流管、粘性塑料单组成。记录接受剖腹探查术患者的临床资料，回顾此类临时性腹部封闭的适应证及其并发症。
13例创伤患者接受了15次负压腹部封闭，其中因腹腔内压力升高导致无法进行无张力筋膜缝合5次（33.3%），再次探查4次（26.7%），损伤控制2次（13.3%），综合因素4次（26.7%）。最终，7例患者（53.8%）直接缝合，5例患者（38.5%）因缺损无法直接缝合，在肉芽形成后接受植皮。1例患者（7.7%）在尝试腹部封闭前死亡。所有患者均未发生肠皮肤瘘和脏器脱出。3例患者（23.1%）发生腹腔内脓肿。
负压包是一种较好的临时性腹部伤口封闭装置，大多数患者可实现一期缝合。该技术操作简单，易于掌握，并发症发生率低。
