Pressure transduction and fluid evacuation during conventional negative pressure wound therapy of the open abdomen and NPWT using a protective disc over the intestines

BMC Surgery

Research Article

Richard Ingemansson¹  Sandra Lindstedt¹  Joanna Hlebowicz²  Malin Malmsjö³  Johan Hansson⁴ 

[1] Department of Cardiothoracic Surgery, Lund University Hospital, SE-221 85, Lund, Sweden;Department of Medicine, Malmö University Hospital, Lund, Sweden;Department of Ophthalmology, Lund University Hospital, Lund, Sweden;Institution of Surgical Sciences, Faculty of Medicine, Uppsala University, Uppsala, Sweden;

关键词: Anterior Abdominal Wall;    Abdominal Compartment Syndrome;    Open Abdomen;    Negative Pressure Wound Therapy;    Wound Edge;   

DOI  :  10.1186/1471-2482-12-4

 received in 2011-07-23, accepted in 2012-03-24,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundNegative pressure wound therapy (NPWT) has gained acceptance among surgeons, for the treatment of open abdomen, since very high closure rates have been reported with this method, compared to other kinds of wound management for the open abdomen. However, the method has occasionally been associated with increased development of fistulae. We have previously shown that NPWT induces ischemia in the underlying small intestines close to the vacuum source, and that a protective disc placed between the intestines and the vacuum source prevents the induction of ischemia. In this study we compare pressure transduction and fluid evacuation of the open abdomen with conventional NPWT and NPWT with a protective disc.MethodsSix pigs underwent midline incision and the application of conventional NPWT and NPWT with a protective disc between the intestines and the vacuum source. The pressure transduction was measured centrally beneath the dressing, and at the anterior abdominal wall, before and after the application of topical negative pressures of -50, -70 and -120 mmHg. The drainage of fluid from the abdomen was measured, with and without the protective disc.ResultsAbdominal drainage was significantly better (p < 0. 001) using NPWT with the protective disc at -120 mmHg (439 ± 25 ml vs. 239 ± 31 ml), at -70 mmHg (341 ± 27 ml vs. 166 ± 9 ml) and at -50 mmHg (350 ± 50 ml vs. 151 ± 21 ml) than with conventional NPWT. The pressure transduction was more even at all pressure levels using NPWT with the protective disc than with conventional NPWT.ConclusionsThe drainage of the open abdomen was significantly more effective when using NWPT with the protective disc than with conventional NWPT. This is believed to be due to the more even and effective pressure transduction in the open abdomen using a protective disc in combination with NPWT.

【 授权许可】

CC BY   
© Lindstedt et al; licensee BioMed Central Ltd. 2012