Slovenská chirurgia 1-2e/2024

Open Abdomen – the VACM technique

Today, open abdomen is an important tool in emergency surgery to deal with and successfully manage the treatment of intra-abdominal disasters. This procedure is reserved for critically ill patients who are at risk of developing abdominal compartment syndrome despite the maximum use of available conservative therapy. From this point of view, it is a life-saving technique whose indications are clearly defined. An important moment in the treatment with the open abdomen procedure is the use of adequate temporary closure and the effort to definitively close the abdominal wall in the shortest possible time, that is, after management of intra-abdominal hypertension and septic complications. By using vacuum therapy in combination with dynamic fascial traction using a mesh (VACM – vacuum and mesh mediated fascial traction), it is possible to achieve a significantly higher rate of definitive closure of the abdominal wall than when using vacuum therapy alone. The aim of this article is to present a case report of a successful case of fascia and abdominal wall closure in the prolonged open abdomen in a patient with developed abdominal compartment syndrome with acute necrotizing pancreatitis using the VACM technique.

Keywords: open abdomen, dynamic closure, negative pressure therapy, fascial closure, mesh mediated fascial traction