The use of vac aspiration system in the treament of abdominal wall phlegmon

Abstract

Introduction: Purulent postoperative complications remain to be a challenge for surgeons even in the 21st century. Septic-purulent complications rate remains high (from 5.0% to 35% of the number of operated patients). As a consequence, morbidity records an increase and also the costs incurred by public medical institution are increased due to the higher number of hospitalization days, an average of 11-14 days. Use of V.A.C. (vacuum assisted closure) asspiration allows to solve problems related to suppurative postoperative complications and provides the ability to minimize the number of hospitalization days thanks to its specific properties in relation to the classic management of these complications.Case report: It is described the clinical case of a patient, 41 years old, with phlegmon of the anterior abdominal wall, developed after abdominoplasty or "tummy tuck". To remove muscle diastasis was used polypropylene mesh fixed to aponeurosis of rectus abdominis muscle. The case was solved using the system for V.A.C. aspiration in intermittent regime with negative pressure 125 mmHg, incomplex with antibacterial treatment, based on the result of microbiological investigation and determination of cultural sensitivity highlighted toward antibacterial preparations, also with immunomodulator and detoxifying treatment. Discussion: This case shows the relevant clinical data for treatment of anterior abdominal wall phlegmon with cosmetic and minimal economic results. Conclusions: VAC aspiration system compared to the classical method of suppurative wound management has a higher number of advantages, among which are the preservation of prosthetic material used in the surgical procedure in particular cases, reducing the frequency of dressing at 48-36 h, which is more convenient for patient and lowers treatment costs, the possibility of continuing treatment in outpatient system etc. Such activity represents an opportunity for surgeons in surgical service of suppuration.