The wound area as a parameter guiding the timing of abdominal closure in the management of patients undergoing open abdominal procedures

A. Senturk, E. Gonullu, Z. Bayhan, Y. Akdeniz, K. Ozdemir, B. Mantoglu, R. Capoglu, N. Firat, F. Altintoprak

General Surgery Department, Sakarya University Training and Research Hospital, Sakarya, Turkey. adem.senturk@saglik.gov.tr

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• Surgery

OBJECTIVE: Surgical site infections (SSI) are incomparably troublesome and complicated, and some of them require an open abdomen (OA) procedure. While deciding the timing of abdominal closure, wound area calculation method and laboratory parameters can be used to guide the timing of abdominal closure after OA procedures.

PATIENTS AND METHODS: The records of the patients who had undergone open abdomen during their treatment course and were followed up with vacuum-assisted closure (VAC) technique between December 2015 and December 2019 were retrospectively analyzed. The laboratory results before the first VAC application and the results after the VAC change were compared to determine a predictive parameter. The ImageJ program was used in five patients to compare the size of the wounds at the time of the decision to close them and before the first VAC application.

RESULTS: 102 patients were analyzed. The ratio of the last wound area to the wound area at the time of the first VAC application in five patients was 0.30, 0.41, 0.34, 0.27, 0.46 (mean: 0.36, standard deviation: 0.078) which were measured and calculated by ImageJ software.

CONCLUSIONS: We think that the concept of wound reduction ratio, which was calculated by a computer program, can be used as a concrete equivalent of the wound closure eligibility criteria decided by clinical experience.

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