| Abstract: Introduction: Treatment of open abdomen following secondary peritonitis is a challenge for surgery and intensive care units (ICU). The aim of this study was to compare three different concurrent treatment strategies.
Methods: Patients suffering an open abdomen following surgery for secondary peritonitis at the Department of General Surgery from 01/01 to 06/04 were investigated. Factor studied: duration of open abdomen, incidence of multi-organ failure, need for surgical revisions, length of stay (LOS) in ICU, nursing requirements (change of dressing/ day), survival and integrity of abdominal wall after discharge. Treatment strategies included: open packing (OP), classic vacuum assisted (VACŪ) –therapy with silicone net protection for the intestine (CV) and VACŪ therapy with “abdominal dressing” a newly developed meshed polyvinyl wrap (AD).
Results: 26 patients were studied: 5 patients were treated with OP, 9 patients with CV and 12 patients with AD. Mean LOS 51 (CV) vs. 43 (AD) days (NS) vs. only 1 surviving patient with OP (72 days), peritonitis related death was 4 (OP) vs. 3 (CV) vs. 1 (AD) (p<0.014 Chisquare test) Median nursing effort was 4 dressings/day (OP), 0.5 (CV) and 0.5 (AD) (p<0.005 OP vs CV, AD Kruskal-Wallis test).
Conclusion: The “abdominal dressing”-therapy seems to be a more efficient treatment option in patients suffering from open abdomen following secondary peritonitis. A trend towards shorter ICU-LOS, lower mortality rates and reduced nursing requirements support our hypothesis.
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