Wound Healing

A recently published study 1 found that vacuum-assisted wound closure achieved early fascial closure in a high percentage of open abdominal wounds after severe trauma, with an acceptable rate of complications. Researchers examined 35 trauma patients with open abdominal wounds managed by vacuum-assisted wound closure in Texas over 26 months. Six of the patients died, leaving 29 patients who were discharged from the hospital. From that group, open abdominal wounds in 25 patients were successfully closed using vacuum-assisted wound closure during a 3-to 18-day range. Of the 4 patients who failed vacuum-assisted wound closure, 2 developed fistulas. None of the patients studied developed evisceration, intra-abdominal abscess, or wound infection. The study population included shock resuscitation patients who had open abdominal wounds treated with vacuum-assisted wound closure. Dressing changes were done at 2- to 3-day intervals and downsized as fascial closure was completed with interrupted suture.

The Trauma Research Database of the University of Texas Health Science Center at Houston was queried to identify patients who had undergone early laparotomy to recognize those patients in whom vacuum-assisted wound closure was used. The database was also used to obtain demographics, shock-related data, and outcomes. Researchers concluded that future areas of investigation for the technique include long-term follow-up to determine rates of ventral hernia and small bowel instruction, as well as results in larger series of patients from different institutions.

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