Treatment of the Open Abdomen with the Commercially Available Vacuum-Assisted Closure System in Patients with Abdominal Sepsis

Excerpt

We thank Dr. Perathoner and colleagues for their interest in our article [1]. The median time interval between the first surgery and the application of the vacuum-assisted closure (VAC) system was 7 (range, 0–17) days. In three patients, the VAC system was applied at time of the primary operation, in 14 patients at time of the first revision (median, 5 days after the primary surgery; range, 1–12 days), and in 13 patients at time of the second revision (median, 11 days after primary surgery; range, 5–17 days). The primary outcome of our study was closure of the fascia, and we did not evaluate or mention the time of use of subcutaneous VAC systems. We are convinced that the crucial steps of treatment are mostly finished when the intra-abdominal sepsis is resolved and the fascia is closed or when an inlay mesh could be implanted. The treatment of the resulting subcutaneous wounds was partially performed in an outpatient setting, and the time intervals would probably not reflect the fastest approach to complete wound closure. …