Faculty Collaboration Database

Temporary abdominal vacuum-packing closure in the neonatal intensive care unit. J Pediatr Surg 2007 Jun;42(6):957-60; discussion 960-1

Date

06/15/2007

Pubmed ID

17560202

DOI

10.1016/j.jpedsurg.2007.01.029

Scopus ID

2-s2.0-34249797022 (requires institutional sign-in at Scopus site)   21 Citations

Abstract

BACKGROUND: Temporary abdominal vacuum-packing (vac-pac) closure is well known in adult literature, yet has not been reported in infants.

METHODS: A review of children in the neonatal intensive care unit who underwent vac-pac closure from 2000 to 2006 was performed.

RESULTS: During this time, 7 infants underwent vac-pac closure after abdominal surgery. Median age was 39 days, with a median weight of 3.2 kg. Reasons for vac-pac included abdominal compartment syndrome (3), ongoing intraabdominal sepsis (1), anticipated second-look procedures (2), and abdominal observation after repair of congenital diaphragmatic hernia on extracorporeal membrane oxygenation (1). PaCO2 revealed a drop from a median preoperative level of 50.3 to 44.0 mm Hg postoperatively. Median preoperative urine output was 3.9 and 3.1 mL/(kg h) postoperatively. One patient died with an open abdomen from overwhelming Escherichia coli sepsis, and all surviving patients (85.7%) proceeded to definitive abdominal closure with the median time of vac-pac use being 4 days.

CONCLUSION: Vac-pac closure in infants is a safe and effective method of temporary abdominal closure. The detrimental effects of intraabdominal hypertension as well as risk of hemorrhage after repair of congenital diaphragmatic hernia while on extracorporeal membrane oxygenation also make this an important technique for abdominal observation.

Author List

Fenton SJ, Dodgion CM, Meyers RL, Nichol PF, Scaife ER

Author

Christopher M. Dodgion MD Associate Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Abdomen
Carbon Dioxide
Diuresis
Female
Gestational Age
Humans
Infant, Newborn
Intensive Care Units, Neonatal
Lower Body Negative Pressure
Male
Occlusive Dressings
Partial Pressure
Reoperation
Respiration, Artificial
Retrospective Studies
Suction
Vacuum