Treatment of the Open Abdomen with Topical Negative Pressure Therapy: A Retrospective Study

Abstract

Background: The management of an open abdomen remains a significant challenge in surgical practice, often requiring specialized wound care strategies to prevent complications such as infections, fluid loss, and delayed closure. Topical negative pressure therapy, also known as negative pressure, wound therapy, has gained attention for its potential in improving wound healing, reducing surgical site infections, and facilitating early abdominal closure. However, its comparative effectiveness against conventional management remains an area of investigation.

Objective: This study evaluates the effectiveness of topical negative pressure therapy in the management of open abdomen cases by assessing abdominal closure rates, infection control, and overall patient outcomes.

Methods: A retrospective analysis was conducted on 60 patients who underwent open abdomen management at a tertiary care hospital. Patients were divided into two groups based on the wound management technique: the topical negative pressure therapy group (n=30), where negative pressure dressings were applied, and the conventional management group (n=30), which received standard open abdomen care without topical negative pressure therapy. Patients with abdominal compartment syndrome, intra-abdominal sepsis, and traumatic bowel injuries were included, while those with malignancies, chronic immunosuppression, or non-survivable injuries were excluded.

The primary outcome measures were successful abdominal closure rates, time to definitive closure, incidence of surgical site infections, and mortality rates. Secondary outcomes included duration of intensive care unit stay, length of hospital stay, and the need for additional surgical interventions. Data analysis was performed using SPSS software, with statistical significance set at p < 0.05.

Results: The mean age of patients was 52.3 ± 14.7 years, with a male predominance of 68.3 percent. The abdominal closure rate in the topical negative pressure therapy group was 76.7 percent compared to 50.0 percent in the conventional group (p = 0.024). The mean time to definitive closure was shorter in the topical negative pressure therapy group (13.4 ± 4.8 days) compared to the conventional group (18.9 ± 5.6 days, p = 0.009). Surgical site infections occurred in 26.7 percent of topical negative pressure therapy patients versus 46.7 percent in the conventional group (p = 0.031). Mortality rates were 16.7 percent in the topical negative pressure therapy group and 26.7 percent in the conventional group (p = 0.215). Intensive care unit stay was significantly reduced in the topical negative pressure therapy group (11.2 ± 3.7 days vs. 15.6 ± 5.2 days, p = 0.014), while the overall hospital stay was similar between groups.

Conclusion: Topical negative pressure therapy demonstrated higher abdominal closure rates, faster time to definitive closure, and reduced surgical site infections compared to conventional management in open abdomen patients. Although mortality rates were not significantly different, the reduction in intensive care unit stay in the topical negative pressure therapy group suggests a potential benefit in optimizing resource utilization. Given these findings, topical negative pressure therapy may serve as an effective adjunct in open abdomen management. Further prospective studies are required to validate these outcomes and develop standardized guidelines for its use.