Short summary

This retrospective multicenter study investigates the impact of vacuum-assisted closure (VAC) compared to on-demand relaparotomy in patients with fecal or diffuse peritonitis. The study evaluates differences in postoperative complications, mortality, reoperation rates, ICU length of stay, and long-term outcomes. Data from multiple hospitals in Denmark will be analyzed to identify the optimal surgical approach in these critically ill patients.

Rationale

Secondary peritonitis due to gastrointestinal perforations is a severe condition associated with high morbidity and mortality. Traditionally, patients undergo relaparotomy based on clinical deterioration, but vacuum-assisted closure (VAC) has emerged as an alternative strategy, allowing for continuous peritoneal drainage and staged abdominal closure. This study aims to compare these two approaches in terms of patient outcomes, including mortality, postoperative complications, and resource utilization.

Description of the cohort

The study includes adult patients (≥18 years) who underwent emergency laparotomy for secondary peritonitis caused by fecal or diffuse contamination. Patients are identified from surgical and intensive care units across multiple hospitals in the Region of Southern Denmark. Exclusion criteria include primary peritonitis, abdominal trauma, and malignancy-related peritonitis.

Data and biological material

The study collects data from electronic patient records, including: Demographics (age, sex, comorbidities) Clinical parameters (ICU admission, organ failure scores) Surgical details (operative findings, reoperations, closure technique) Outcomes (mortality, complications, hospital stay, resource utilization) Registry data (National Patient Registry, Cause of Death Registry) No biological samples will be collected for this study.

Collaborating researchers and departments

Department of Surgery, OUH

• Mark Bremholm Ellebæk

Publications associated with the project

Vacuum‐Assisted Closure Significantly Reduces Surgical Postoperative Complications Compared With Primary Abdominal Closure in Patients With Secondary Peritonitis: A Comparative Retrospective Study Pooya Rajabaleyan1,2 | Ask Vang1 | Sören Möller2 | Sardar Khalaf1 | Anna Gosvig Ladegaard1 | Niels Qvist1,2 | Mark Bremholm Ellebæk1,2