Despite ongoing progress in the surgical treatment of ruptured abdominal aortic aneurysms (RAAA), thirty-day postoperative mortality reaches 30 to even 55 percent. Multi organ dysfunction syndrome (MODS) is postulated to be the main cause of patients’ deaths following RAAA repair. The recognized underlining mechanisms comprises: intra-abdominal hypertension (IAH) leading to abdominal compartment syndrome, superimposed with visceral perfusion dysfunction. The objective of this study was to assess the effectiveness of delayed abdominal closure with the utility of negative pressure dressing in the improvement of ruptured aortic aneurysm repair outcome.
Methods
From January 2013 to December 2016, 97 patients with RAAA were successfully operated. In the initial 54 consecutive cases (group I), operative procedure ended with primary abdominal closure, whereas in 43 subsequent patients (group II), negative pressure dressing was used for the purpose of temporary abdominal closure aortic repair. The following parameters where comparatively analysed: duration of operation, mortality rate, reoperation rate, ischemic bowel complication rate, recovery time, intensive care stay and comfort of postoperative patients’ care.
Results
Among evaluated variables, no significant differences between groups where noticed in exception of duration of operation, that was significantly longer in the group I. However, in group II we observed trend towards higher reoperative rate, with lower incidence of ischemic bowel complication. Also, average recovery time and length of intensive care stay was favourable for the group II. Subjectively assessed comfort of postoperative nursing care was similarly higher among patients obtaining negative pressure dressing abdomen closure.
Conclusion
Among evaluated variables, no significant differences between groups where noticed in exception of duration of operation, that was significantly longer in the group I. However, in group II we observed trend towards higher reoperative rate, with lower incidence of ischemic bowel complication. Also, average recovery time and length of intensive care stay was favourable for the group II. Subjectively assessed comfort of postoperative nursing care was similarly higher among patients obtaining negative pressure dressing abdomen closure.
