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Vacuum-assisted closure (VAC) has been used in our centre to aid the closure of abdominal wounds. The aim of this study was to examine the clinical outcome of patients in whom VAC therapy had been used in conjunction with laparostomy.All patients in whom VAC was used in the management of open abdominal wounds from November 2003 to March 2005 were included in this study.There were 29 patients in the study. Nineteen (65.5%) needed ICU care. Six (20%) patients developed leakage of small bowel contents into the abdominal wound cavity because of intestinal fistulation during the VAC therapy. Four of the six (66%) died, all from multi-organ failure.Our study has demonstrated a high incidence of intestinal leakage following VAC therapy. The reasons for this are multifactorial. We would recommend caution in using it on patients with bowel anastomoses or enterotomy repairs.