Fascial abdominal closure is a key factor of effective VAC-assisted laparostomy

Shchegolev A.A.; Tovmasyan R.S.; Markarov A.E.; Chevokin A.Yu.; Vasiliev M.V.; Plotnikov V.V.; Muradyan T.G.

doi:https://doi.org/10.17116/hirurgia202504161

Shchegolev A.A.

Pirogov Russian National Research Medical University;
Inozemtsev Municipal Clinical Hospital

ORCID: 0000-0002-1423-4284

Tovmasyan R.S.

Pirogov Russian National Research Medical University;
Inozemtsev Municipal Clinical Hospital

ORCID: 0000-0002-0699-7521

Markarov A.E.

Inozemtsev City Clinical Hospital

ORCID: 0000-0002-0392-8280

Chevokin A.Yu.

Pirogov Russian National Research Medical University;
Inozemtsev Municipal Clinical Hospital

ORCID: 0000-0002-8814-9728

Vasiliev M.V.

Pirogov Russian National Research Medical University;
Inozemtsev Municipal Clinical Hospital

ORCID: 0000-0003-4688-0122

Plotnikov V.V.

Pirogov Russian National Research Medical University;
Inozemtsev Municipal Clinical Hospital

ORCID: 0000-0001-7198-2820

Muradyan T.G.

Pirogov Russian National Research Medical University

ORCID: 0000-0002-4322-4958

Fascial abdominal closure is a key factor of effective VAC-assisted laparostomy

Authors:

Shchegolev A.A., Tovmasyan R.S., Markarov A.E., Chevokin A.Yu., Vasiliev M.V., Plotnikov V.V., Muradyan T.G.

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Journal: Pirogov Russian Journal of Surgery. 2025;(4): 61‑70

DOI: 10.17116/hirurgia202504161

Read: 920 times

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To cite this article:

Shchegolev AA, Tovmasyan RS, Markarov AE, Chevokin AYu, Vasiliev MV, Plotnikov VV, Muradyan TG. Fascial abdominal closure is a key factor of effective VAC-assisted laparostomy. Pirogov Russian Journal of Surgery. 2025;(4):61‑70. (In Russ.)
https://doi.org/10.17116/hirurgia202504161

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

OBJECTIVE

To evaluate the efficiency of various methods of primary fascial abdominal closure in VAC-laparostomy.

MATERIAL AND METHODS

The study included 94 patients with traumatic and non-traumatic abdominal disasters. Treatment strategy of «open abdomen» (OA) was used. The following methods of fascial closure (FC) were used: primary fascial suturing (PFS) and various options for vacuum-assisted closure (VAC) including options without alloplasty (VAC-suturing) and with abdominal wall alloplasty (VAC-alloplasty).

RESULTS

The overall mortality was 34% (32 patients). Of these, 26 ones died before FC (27.7% of total number of patients and 81.2% of total number of deaths), and 6 patients after FC onset (6.4% of total number of patients and 18.8% of total number of deaths). Attempts of FC were made in 68 patients. Successful FC was performed in 45 patients (66.2% of all attempts).

CONCLUSION

The best results were achieved after VAC-alloplasty (IPOM in-lay). FC through VAC-alloplasty with OA strategy significantly improves the results of treatment.

Keywords:

abdominal sepsis

peritonitis

«open abdomen»

VAC-laparostomy

fascial closure

vacuum-assisted laparostomy

Authors:

Shchegolev A.A.

Pirogov Russian National Research Medical University;
Inozemtsev Municipal Clinical Hospital

ORCID: 0000-0002-1423-4284

Tovmasyan R.S.

Pirogov Russian National Research Medical University;
Inozemtsev Municipal Clinical Hospital

ORCID: 0000-0002-0699-7521

Markarov A.E.

Inozemtsev City Clinical Hospital

ORCID: 0000-0002-0392-8280

Chevokin A.Yu.

Pirogov Russian National Research Medical University;
Inozemtsev Municipal Clinical Hospital

ORCID: 0000-0002-8814-9728

Vasiliev M.V.

Pirogov Russian National Research Medical University;
Inozemtsev Municipal Clinical Hospital

ORCID: 0000-0003-4688-0122

Plotnikov V.V.

Pirogov Russian National Research Medical University;
Inozemtsev Municipal Clinical Hospital

ORCID: 0000-0001-7198-2820

Muradyan T.G.

Pirogov Russian National Research Medical University

ORCID: 0000-0002-4322-4958

Received:

04.09.2024

Accepted:

04.10.2024

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References:

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