Internal vacuum-assisted closure device in the swine model of severe liver injury

World Journal of Emergency Surgery

Michael Moncure³  Bruce W Thomas¹  Christopher B Everett² 

[1] Department of Surgery, The University of Kansas School of Medicine-Wichita, 929 N. Saint Francis Street, Wichita, Kansas 67214, USA;Department of Surgery, The University of Kansas School of Medicine-Wichita, Wichita, Kansas, USA;Department of Surgery, Kansas University Medical Center, Kansas City, Kansas, USA

关键词: Hemorrhage;    Swine model;    Negative-pressure therapy;    Liver trauma;   

Others  :  792140
DOI  :  10.1186/1749-7922-7-38

 received in 2012-09-18, accepted in 2012-11-08,  发布年份 2012

【 摘 要 】

Objectives

The authors present a novel approach to nonresectional therapy in major hepatic trauma utilizing intraabdominal perihepatic vacuum assisted closure (VAC) therapy in the porcine model of Grade V liver injury.

Methods

A Grade V injury was created in the right lobe of the liver in a healthy pig. A Pringle maneuver was applied (4.5 minutes total clamp time) and a vacuum assisted closure device was placed over the injured lobe and connected to suction. The device consisted of a perforated plastic bag placed over the liver, followed by a 15 cm by 15cm VAC sponge covered with a nonperforated plastic bag. The abdomen was closed temporarily. Blood loss, cardiopulmonary parameters and bladder pressures were measured over a one-hour period. The device was then removed and the animal was euthanized.

Results

Feasibility of device placement was demonstrated by maintenance of adequate vacuum suction pressures and seal. VAC placement presented no major technical challenges. Successful control of ongoing liver hemorrhage was achieved with the VAC. Total blood loss was 625 ml (20ml/kg). This corresponds to class II hemorrhagic shock in humans and compares favorably to previously reported estimated blood losses with similar grade liver injuries in the swine model. No post-injury cardiopulmonary compromise or elevated abdominal compartment pressures were encountered, while hepatic parenchymal perfusion was maintained.

Conclusion

These data demonstrate the feasibility and utility of a perihepatic negative pressure device for the treatment of hemorrhage from severe liver injury in the porcine model.

【 授权许可】

   
2012 Everett et al.; licensee BioMed Central Ltd.

【 图 表 】

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