2010 Volume 21 Issue 10 Pages 835-842
Background & Aims: In damage control surgery (DCS) on patients with severe multiple trauma, it is important to complete the operation promptly in order to prevent the development of acute abdominal compartment syndrome (ACS) after operation. We selected vacuum packing closure (VPC) to achieve temporary abdominal closure during DCS and reported the advantages of this procedure. Few studies have reported a comparison between VPC and other methods. In this study, we compared VPC with other methods (including skin closure and silo closure) and evaluated the advantages of VPC.
Methods: Medical records of trauma patients who had undergone DCS from 1994 to 2008 were reviewed. The operation time, total volume of intravenous infusion, development of ACS, and prognosis of patients were compared between VPC and other methods.
Results: A total of 101 VPCs were performed in 58 trauma patients, and 33 other closure procedures were performed in 29 patients. There were no significant background differences between both groups. ACS developed in only 1 patient (1.7%) who underwent VPC and in 7 patients (24.1%) who underwent other closure procedures, although there was no significant difference in the total volume of intravenous infusion between both groups. These findings suggested that VPC prevents ACS after the initial operation of DCS. The prognosis of patients who underwent VPC was superior to the prognosis of those who underwent other closure procedures (survival rate: VPC 51.7% vs. other closure procedures 37.9%).
Conclusion: VPC is an excellent method to achieve temporary closure in DCS because it is possible to complete the operation promptly and to prevent ACS after DCS.
