Fenton Stephen J, Dodgion Christopher M, Meyers Rebecka L, Nichol Peter F, Scaife Eric R
Department of Surgery, University of Utah, Salt Lake City, UT 84132, USA.
J Pediatr Surg. 2007 Jun;42(6):957-60; discussion 960-1. doi: 10.1016/j.jpedsurg.2007.01.029.
Temporary abdominal vacuum-packing (vac-pac) closure is well known in adult literature, yet has not been reported in infants.
A review of children in the neonatal intensive care unit who underwent vac-pac closure from 2000 to 2006 was performed.
During this time, 7 infants underwent vac-pac closure after abdominal surgery. Median age was 39 days, with a median weight of 3.2 kg. Reasons for vac-pac included abdominal compartment syndrome (3), ongoing intraabdominal sepsis (1), anticipated second-look procedures (2), and abdominal observation after repair of congenital diaphragmatic hernia on extracorporeal membrane oxygenation (1). PaCO2 revealed a drop from a median preoperative level of 50.3 to 44.0 mm Hg postoperatively. Median preoperative urine output was 3.9 and 3.1 mL/(kg h) postoperatively. One patient died with an open abdomen from overwhelming Escherichia coli sepsis, and all surviving patients (85.7%) proceeded to definitive abdominal closure with the median time of vac-pac use being 4 days.
Vac-pac closure in infants is a safe and effective method of temporary abdominal closure. The detrimental effects of intraabdominal hypertension as well as risk of hemorrhage after repair of congenital diaphragmatic hernia while on extracorporeal membrane oxygenation also make this an important technique for abdominal observation.
临时腹部真空包装（真空袋）闭合术在成人文献中已广为人知，但在婴儿中尚未见报道。
对2000年至2006年在新生儿重症监护病房接受真空袋闭合术的儿童进行回顾性研究。
在此期间，7例婴儿在腹部手术后接受了真空袋闭合术。中位年龄为39天，中位体重为3.2千克。进行真空袋闭合术的原因包括腹腔间隔室综合征（3例）、持续性腹腔内感染（1例）、预期的二次探查手术（2例）以及在体外膜肺氧合支持下修复先天性膈疝后进行腹部观察（1例）。二氧化碳分压显示从术前中位水平50.3毫米汞柱降至术后44.0毫米汞柱。术前中位尿量为3.9毫升/（千克·小时），术后为3.1毫升/（千克·小时）。1例患者因严重大肠杆菌感染导致腹部开放而死亡，所有存活患者（85.7%）均进行了确定性腹部闭合术，真空袋使用的中位时间为4天。
婴儿真空袋闭合术是一种安全有效的临时腹部闭合方法。腹腔内高压的有害影响以及在体外膜肺氧合支持下修复先天性膈疝后出血的风险也使该技术成为腹部观察的重要手段。
