Effects of Time to Application of Negative Pressure Therapy on Abdominal Infections after Colonic Perforation

BACKGROUND: Negative pressure therapy (NPT) seems to improve surgical outcomes in open abdomen (OA) management of severe intra-abdominal infections (IAIs). The aim of this study was to compare the effects of immediate vs. delayed application of NPT on outcomes in patients with IAIs after colonic perforation. MATERIALS AND METHODS: We analysed 38 patients who received NPT during OA management for IAI after colonic perforation. The endpoints were treatment duration, definitive fascial closure and in-hospital mortality. We subdivided patients according to the timing of NPT application: immediate (at the end of the first OA procedure) and delayed (at I-II revision, at III revision, and after III revision). RESULTS: NPT was applied immediately in 15 cases (39.5%) and was delayed in 23 (60.5%): 14 (36.8%) at I-II revision, 7 (18.4%) at III revision, and 2 (5.3%) after III revision. Immediate NPT application was associated with the best outcomes. CONCLUSIONS: NPT should be used as soon as possible in OA management for IAIs due to colonic perforation.