High risk of fistula formation in vacuum-assisted closure therapy in patients with open abdomen due to secondary peritonitis—a retrospective analysis
Purpose The aim of this study was to evaluate the efficacy of vacuum-assisted closure therapy in patients with open abdomen due to secondary peritonitis and to identify possible risk factors of fistula formation. Methods The hospital OPS-database (time period 2005–2014) was searched to identify pati...
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| Veröffentlicht in: | Langenbeck's archives of surgery 2016-08, Vol.401 (5), p.619-625 |
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| creator | Mintziras, Ioannis Miligkos, Michael Bartsch, Detlef Klaus |
| description | Purpose
The aim of this study was to evaluate the efficacy of vacuum-assisted closure therapy in patients with open abdomen due to secondary peritonitis and to identify possible risk factors of fistula formation.
Methods
The hospital OPS-database (time period 2005–2014) was searched to identify patients treated with an open abdomen due to secondary peritonitis, who underwent vacuum-assisted closure therapy. Medical records were retrospectively analyzed for patients’ characteristics, cause of peritonitis, duration of vacuum therapy, number of relaparotomies, fascial closure rates, and risk factors of fistula formation.
Results
Forty-three patients (19 male, 24 female) with a median age of 65 years (range 24–90 years) were identified. The major cause of secondary peritonitis was anastomotic leakage after intestinal anastomosis or bowel perforation, the median APACHE II score was 11. Median duration of VAC treatment was 12 days (range 3–88 days). Twenty of 43 (47 %) patients died from septic complications. Delayed fascial closure was obtained by suturing in 20 of 43 patients (47 %). Overall 16 of 43 (37 %) patients developed enteroatmospheric fistulas. Re-explorations after starting VAC treatment and duration of VAC therapy were significantly associated with the occurrence of enteroatmospheric fistulas (
p
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| doi_str_mv | 10.1007/s00423-016-1443-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1803452299</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1803452299</sourcerecordid><originalsourceid>FETCH-LOGICAL-c344t-415d95fdf5ef6c39556ef85b07bc2d547a458c85362ff0fab6967f525693666c3</originalsourceid><addsrcrecordid>eNp9kc1u1TAQhSMEoqXwAGyQl2wCdvyTZIkqoEiV2MDacpxxr0tiB49dlB0PgcT78ST46pYuWc1I850zY5-mecnoG0Zp_xYpFR1vKVMtE4K3-6PmnAku205I9vihF_yseYZ4SylV_SieNmddzyQVfDhvfl_5mwNJHr-R6IjzmMtiiItpNdnHQHwgd8aWsrYGsU5hJnaJWBKQfIBktv2IbBWGkJH88PlA4gaBmGmOa61zqWQkCDaG2aSdbJB8jsFnj39-_jIkQU4RN7DZ3wExwSx7XfS8eeLMgvDivl40Xz-8_3J51V5__vjp8t11a7kQuRVMzqN0s5PglOWjlArcICfaT7abpeiNkIMdJFedc9SZSY2qd7KTauRKVcVF8_rku6X4vQBmvXq0sCwmQCyo2UC5kF03jhVlJ9TWezGB01vya32SZlQf89CnPHTNQx_z0HvVvLq3L9MK84PiXwAV6E4A1lG4gaRvY0n1E_A_rn8BcfybMA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1803452299</pqid></control><display><type>article</type><title>High risk of fistula formation in vacuum-assisted closure therapy in patients with open abdomen due to secondary peritonitis—a retrospective analysis</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Mintziras, Ioannis ; Miligkos, Michael ; Bartsch, Detlef Klaus</creator><creatorcontrib>Mintziras, Ioannis ; Miligkos, Michael ; Bartsch, Detlef Klaus</creatorcontrib><description>Purpose
The aim of this study was to evaluate the efficacy of vacuum-assisted closure therapy in patients with open abdomen due to secondary peritonitis and to identify possible risk factors of fistula formation.
Methods
The hospital OPS-database (time period 2005–2014) was searched to identify patients treated with an open abdomen due to secondary peritonitis, who underwent vacuum-assisted closure therapy. Medical records were retrospectively analyzed for patients’ characteristics, cause of peritonitis, duration of vacuum therapy, number of relaparotomies, fascial closure rates, and risk factors of fistula formation.
Results
Forty-three patients (19 male, 24 female) with a median age of 65 years (range 24–90 years) were identified. The major cause of secondary peritonitis was anastomotic leakage after intestinal anastomosis or bowel perforation, the median APACHE II score was 11. Median duration of VAC treatment was 12 days (range 3–88 days). Twenty of 43 (47 %) patients died from septic complications. Delayed fascial closure was obtained by suturing in 20 of 43 patients (47 %). Overall 16 of 43 (37 %) patients developed enteroatmospheric fistulas. Re-explorations after starting VAC treatment and duration of VAC therapy were significantly associated with the occurrence of enteroatmospheric fistulas (
p
< 0.001). ROC curve analysis determined the optimal duration of VAC therapy to reduce the risk of fistula formation at 13 days.
Conclusions
Long-term VAC treatment of patients with an open abdomen due to secondary peritonitis results in a relatively low fascial closure rate and a high risk of fistula formation.</description><identifier>ISSN: 1435-2443</identifier><identifier>EISSN: 1435-2451</identifier><identifier>DOI: 10.1007/s00423-016-1443-y</identifier><identifier>PMID: 27150438</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Abdominal Surgery ; Abdominal Wall ; Abdominal Wound Closure Techniques ; Adult ; Aged ; Aged, 80 and over ; Cardiac Surgery ; Female ; General Surgery ; Humans ; Intestinal Fistula - etiology ; Intestinal Fistula - prevention & control ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Negative-Pressure Wound Therapy - adverse effects ; Original Article ; Peritonitis - surgery ; Postoperative Complications - etiology ; Postoperative Complications - prevention & control ; Retrospective Studies ; Risk Factors ; Thoracic Surgery ; Traumatic Surgery ; Treatment Outcome ; Vascular Surgery ; Young Adult</subject><ispartof>Langenbeck's archives of surgery, 2016-08, Vol.401 (5), p.619-625</ispartof><rights>Springer-Verlag Berlin Heidelberg 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c344t-415d95fdf5ef6c39556ef85b07bc2d547a458c85362ff0fab6967f525693666c3</citedby><cites>FETCH-LOGICAL-c344t-415d95fdf5ef6c39556ef85b07bc2d547a458c85362ff0fab6967f525693666c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00423-016-1443-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00423-016-1443-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27150438$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mintziras, Ioannis</creatorcontrib><creatorcontrib>Miligkos, Michael</creatorcontrib><creatorcontrib>Bartsch, Detlef Klaus</creatorcontrib><title>High risk of fistula formation in vacuum-assisted closure therapy in patients with open abdomen due to secondary peritonitis—a retrospective analysis</title><title>Langenbeck's archives of surgery</title><addtitle>Langenbecks Arch Surg</addtitle><addtitle>Langenbecks Arch Surg</addtitle><description>Purpose
The aim of this study was to evaluate the efficacy of vacuum-assisted closure therapy in patients with open abdomen due to secondary peritonitis and to identify possible risk factors of fistula formation.
Methods
The hospital OPS-database (time period 2005–2014) was searched to identify patients treated with an open abdomen due to secondary peritonitis, who underwent vacuum-assisted closure therapy. Medical records were retrospectively analyzed for patients’ characteristics, cause of peritonitis, duration of vacuum therapy, number of relaparotomies, fascial closure rates, and risk factors of fistula formation.
Results
Forty-three patients (19 male, 24 female) with a median age of 65 years (range 24–90 years) were identified. The major cause of secondary peritonitis was anastomotic leakage after intestinal anastomosis or bowel perforation, the median APACHE II score was 11. Median duration of VAC treatment was 12 days (range 3–88 days). Twenty of 43 (47 %) patients died from septic complications. Delayed fascial closure was obtained by suturing in 20 of 43 patients (47 %). Overall 16 of 43 (37 %) patients developed enteroatmospheric fistulas. Re-explorations after starting VAC treatment and duration of VAC therapy were significantly associated with the occurrence of enteroatmospheric fistulas (
p
< 0.001). ROC curve analysis determined the optimal duration of VAC therapy to reduce the risk of fistula formation at 13 days.
Conclusions
Long-term VAC treatment of patients with an open abdomen due to secondary peritonitis results in a relatively low fascial closure rate and a high risk of fistula formation.</description><subject>Abdominal Surgery</subject><subject>Abdominal Wall</subject><subject>Abdominal Wound Closure Techniques</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cardiac Surgery</subject><subject>Female</subject><subject>General Surgery</subject><subject>Humans</subject><subject>Intestinal Fistula - etiology</subject><subject>Intestinal Fistula - prevention & control</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Negative-Pressure Wound Therapy - adverse effects</subject><subject>Original Article</subject><subject>Peritonitis - surgery</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - prevention & control</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Thoracic Surgery</subject><subject>Traumatic Surgery</subject><subject>Treatment Outcome</subject><subject>Vascular Surgery</subject><subject>Young Adult</subject><issn>1435-2443</issn><issn>1435-2451</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1TAQhSMEoqXwAGyQl2wCdvyTZIkqoEiV2MDacpxxr0tiB49dlB0PgcT78ST46pYuWc1I850zY5-mecnoG0Zp_xYpFR1vKVMtE4K3-6PmnAku205I9vihF_yseYZ4SylV_SieNmddzyQVfDhvfl_5mwNJHr-R6IjzmMtiiItpNdnHQHwgd8aWsrYGsU5hJnaJWBKQfIBktv2IbBWGkJH88PlA4gaBmGmOa61zqWQkCDaG2aSdbJB8jsFnj39-_jIkQU4RN7DZ3wExwSx7XfS8eeLMgvDivl40Xz-8_3J51V5__vjp8t11a7kQuRVMzqN0s5PglOWjlArcICfaT7abpeiNkIMdJFedc9SZSY2qd7KTauRKVcVF8_rku6X4vQBmvXq0sCwmQCyo2UC5kF03jhVlJ9TWezGB01vya32SZlQf89CnPHTNQx_z0HvVvLq3L9MK84PiXwAV6E4A1lG4gaRvY0n1E_A_rn8BcfybMA</recordid><startdate>20160801</startdate><enddate>20160801</enddate><creator>Mintziras, Ioannis</creator><creator>Miligkos, Michael</creator><creator>Bartsch, Detlef Klaus</creator><general>Springer Berlin Heidelberg</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160801</creationdate><title>High risk of fistula formation in vacuum-assisted closure therapy in patients with open abdomen due to secondary peritonitis—a retrospective analysis</title><author>Mintziras, Ioannis ; Miligkos, Michael ; Bartsch, Detlef Klaus</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c344t-415d95fdf5ef6c39556ef85b07bc2d547a458c85362ff0fab6967f525693666c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Abdominal Surgery</topic><topic>Abdominal Wall</topic><topic>Abdominal Wound Closure Techniques</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cardiac Surgery</topic><topic>Female</topic><topic>General Surgery</topic><topic>Humans</topic><topic>Intestinal Fistula - etiology</topic><topic>Intestinal Fistula - prevention & control</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Negative-Pressure Wound Therapy - adverse effects</topic><topic>Original Article</topic><topic>Peritonitis - surgery</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - prevention & control</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Thoracic Surgery</topic><topic>Traumatic Surgery</topic><topic>Treatment Outcome</topic><topic>Vascular Surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mintziras, Ioannis</creatorcontrib><creatorcontrib>Miligkos, Michael</creatorcontrib><creatorcontrib>Bartsch, Detlef Klaus</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Langenbeck's archives of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mintziras, Ioannis</au><au>Miligkos, Michael</au><au>Bartsch, Detlef Klaus</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High risk of fistula formation in vacuum-assisted closure therapy in patients with open abdomen due to secondary peritonitis—a retrospective analysis</atitle><jtitle>Langenbeck's archives of surgery</jtitle><stitle>Langenbecks Arch Surg</stitle><addtitle>Langenbecks Arch Surg</addtitle><date>2016-08-01</date><risdate>2016</risdate><volume>401</volume><issue>5</issue><spage>619</spage><epage>625</epage><pages>619-625</pages><issn>1435-2443</issn><eissn>1435-2451</eissn><abstract>Purpose
The aim of this study was to evaluate the efficacy of vacuum-assisted closure therapy in patients with open abdomen due to secondary peritonitis and to identify possible risk factors of fistula formation.
Methods
The hospital OPS-database (time period 2005–2014) was searched to identify patients treated with an open abdomen due to secondary peritonitis, who underwent vacuum-assisted closure therapy. Medical records were retrospectively analyzed for patients’ characteristics, cause of peritonitis, duration of vacuum therapy, number of relaparotomies, fascial closure rates, and risk factors of fistula formation.
Results
Forty-three patients (19 male, 24 female) with a median age of 65 years (range 24–90 years) were identified. The major cause of secondary peritonitis was anastomotic leakage after intestinal anastomosis or bowel perforation, the median APACHE II score was 11. Median duration of VAC treatment was 12 days (range 3–88 days). Twenty of 43 (47 %) patients died from septic complications. Delayed fascial closure was obtained by suturing in 20 of 43 patients (47 %). Overall 16 of 43 (37 %) patients developed enteroatmospheric fistulas. Re-explorations after starting VAC treatment and duration of VAC therapy were significantly associated with the occurrence of enteroatmospheric fistulas (
p
< 0.001). ROC curve analysis determined the optimal duration of VAC therapy to reduce the risk of fistula formation at 13 days.
Conclusions
Long-term VAC treatment of patients with an open abdomen due to secondary peritonitis results in a relatively low fascial closure rate and a high risk of fistula formation.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>27150438</pmid><doi>10.1007/s00423-016-1443-y</doi><tpages>7</tpages></addata></record> |
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| subjects | Abdominal Surgery Abdominal Wall Abdominal Wound Closure Techniques Adult Aged Aged, 80 and over Cardiac Surgery Female General Surgery Humans Intestinal Fistula - etiology Intestinal Fistula - prevention & control Male Medicine Medicine & Public Health Middle Aged Negative-Pressure Wound Therapy - adverse effects Original Article Peritonitis - surgery Postoperative Complications - etiology Postoperative Complications - prevention & control Retrospective Studies Risk Factors Thoracic Surgery Traumatic Surgery Treatment Outcome Vascular Surgery Young Adult |
| title | High risk of fistula formation in vacuum-assisted closure therapy in patients with open abdomen due to secondary peritonitis—a retrospective analysis |
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