Negative Pressure Wound Therapy of Open Abdomen and Definitive Closure Techniques After Decompressive Laparotomy: A Single-center Observational Prospective Study

Introduction. Open abdomen is a concept that was developed especially in relation to abdominal compartment syndrome (ACS). Objective. This study presents the evolution and complications related to the management of the open abdomen after decompressive laparotomy, using a standardized method based on negative pressure wound therapy (NPWT). Materials and Methods. This observational prospective study conducted over a 9-month period included 19 patients who underwent decompressive laparotomies for ACS. The triggering conditions were peritonitis, infected and noninfected acute pancreatitis, ileus, and trauma. Temporary abdominal closure was performed using NPWT and the final closure by primary suture or dual mesh. Intra-abdominal pressure was permanently and indirectly monitored transvesically. Results. After decompressive laparotomy, the intra-abdominal pressure decreased significantly (P < .001) compared with the value preoperatively (41.4 mm Hg to 15.3 mm Hg). Mortality was 21.2%, with higher rates for acute pancreatitis (odds ratio [OR] = 3.75) and trauma (OR = 1.25) due to the severity of the primary illness. The final closure was performed after 11.7 days, and primary closure was possible in 4 cases. Conclusions. Decompressive laparotomy significantly reduced intra-abdominal pressure for ACS, improving the prognosis.