Lopez Gregory, Clifton-Koeppel Robin, Emil Sherif
Division of Pediatric Surgery, University Children's Hospital, University of California Irvine School of Medicine, Orange, CA 92868, USA.
J Pediatr Surg. 2008 Dec;43(12):2202-7. doi: 10.1016/j.jpedsurg.2008.08.067.
Neonatal experience in vacuum-assisted closure (VAC) for complex abdominal wounds remains scant.
A neonatal VAC protocol was instituted in 2004. The medical records of patients treated with this protocol for the ensuing 3 years were retrospectively reviewed. Continuous data are reported as mean +/- SD (range).
Ten VAC applications occurred in 8 neonates for a 3-year period. Gestational age and age at VAC application were 30 +/- 6.9 (24-40) weeks and 84.5 +/- 51 (21-165) days, respectively. Birth weight and weight at VAC application were 1495 +/- 1118 (615-3415) g and 3515 +/- 2118 (989-7965) g, respectively. All wound complications occurred after laparotomies (7 elective, 3 emergent). Three wounds included intestinal stomas, and 3 included enterocutaneous fistulae. Average wound area at VAC initiation was 13.6 +/- 6.0 (8.5-25) cm(2). Duration of VAC use was 19.1 +/- 15.3 (7-60) days. Vacuum-assisted closure resulted in complete wound closure in all cases and did not result in any local or systemic complications. Five patients (63%) survived to discharge.
Vacuum-assisted closure for complicated abdominal wounds is safe and successful in neonates of any gestational age and birth weight. It provides effective wound management, even in the presence of stomas or enterocutaneous fistulae.
关于新生儿应用负压封闭引流（VAC）治疗复杂腹部伤口的经验仍然很少。
2004年制定了新生儿VAC方案。回顾性分析了随后3年采用该方案治疗的患者的病历。连续数据以平均值±标准差（范围）报告。
在3年期间，8例新生儿接受了10次VAC治疗。VAC治疗时的胎龄和年龄分别为30±6.9（24 - 40）周和84.5±51（21 - 165）天。出生体重和VAC治疗时的体重分别为1495±1118（615 - 3415）g和3515±2118（989 - 7965）g。所有伤口并发症均发生在剖腹手术后（7例择期手术，3例急诊手术）。3个伤口包括肠造口，3个伤口包括肠皮肤瘘。VAC开始时的平均伤口面积为13.6±6.0（8.5 - 25）cm²。VAC使用时间为19.1±15.3（7 - 60）天。负压封闭引流使所有病例的伤口完全闭合，未导致任何局部或全身并发症。5例患者（63%）存活至出院。
负压封闭引流治疗复杂腹部伤口对任何胎龄和出生体重的新生儿都是安全且成功的。即使存在造口或肠皮肤瘘，它也能提供有效的伤口管理。
