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Macroscopic changes during negative pressure wound therapy of the open abdomen using conventional negative pressure wound therapy and NPWT with a protective disc over the intestines.

Lindstedt Ingemansson, Sandra LU ; Malmsjö, Malin LU ; Hansson, Johan; Hlebowicz, Joanna LU and Ingemansson, Richard LU (2011) In BMC Surgery 11.
Abstract
BACKGROUND: Higher closure rates of the open abdomen have been reported with negative pressure wound therapy (NPWT) than with other wound management techniques. 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 the present study we compare macroscopic changes after 12, 24, and 48 hours, using conventional NPWT and NPWT with a protective disc between the intestines and the vacuum source.



METHODS:

Twelve pigs underwent midline incision. Six... (More)
BACKGROUND: Higher closure rates of the open abdomen have been reported with negative pressure wound therapy (NPWT) than with other wound management techniques. 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 the present study we compare macroscopic changes after 12, 24, and 48 hours, using conventional NPWT and NPWT with a protective disc between the intestines and the vacuum source.



METHODS:

Twelve pigs underwent midline incision. Six animals underwent conventional NPWT, while the other six pigs underwent NPWT with a protective disc inserted between the intestines and the vacuum source. Macroscopic changes were photographed and quantified after 12, 24, and 48 hours of NPWT.



RESULTS:

The surface of the small intestines was red and mottled as a result of petechial bleeding in the intestinal wall in all cases. After 12, 24 and 48 hours of NPWT, the area of petechial bleeding was significantly larger when using conventional NPWT than when using NPWT with the protective disc (9.7 ± 1.0 cm2 vs. 1.8 ± 0.2 cm2, p < 0.001, 12 hours), (14.5 ± 0.9 cm2 vs. 2.0 ± 0.2 cm2, 24 hours) (17.0 ± 0.7 cm2 vs. 2.5 ± 0.2 cm2 with the disc, p < 0.001, 48 hours)



CONCLUSIONS:

The areas of petechial bleeding in the small intestinal wall were significantly larger following conventional NPWT after 12, 24 and 48 hours, than using NPWT with a protective disc between the intestines and the vacuum source. The protective disc protects the intestines, reducing the amount of petechial bleeding. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BMC Surgery
volume
11
publisher
BioMed Central
external identifiers
  • WOS:000296449000001
  • PMID:21529362
  • Scopus:79955367556
ISSN
1471-2482
DOI
10.1186/1471-2482-11-10
language
English
LU publication?
yes
id
5fbbff2b-fa90-4006-b1dd-d3129d2f6e0d (old id 1973344)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21529362?dopt=Abstract
date added to LUP
2011-06-07 09:12:58
date last changed
2017-01-01 07:52:56
@article{5fbbff2b-fa90-4006-b1dd-d3129d2f6e0d,
  abstract     = {BACKGROUND: Higher closure rates of the open abdomen have been reported with negative pressure wound therapy (NPWT) than with other wound management techniques. 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 the present study we compare macroscopic changes after 12, 24, and 48 hours, using conventional NPWT and NPWT with a protective disc between the intestines and the vacuum source.<br/><br>
<br/><br>
METHODS:<br/><br>
Twelve pigs underwent midline incision. Six animals underwent conventional NPWT, while the other six pigs underwent NPWT with a protective disc inserted between the intestines and the vacuum source. Macroscopic changes were photographed and quantified after 12, 24, and 48 hours of NPWT.<br/><br>
<br/><br>
RESULTS:<br/><br>
The surface of the small intestines was red and mottled as a result of petechial bleeding in the intestinal wall in all cases. After 12, 24 and 48 hours of NPWT, the area of petechial bleeding was significantly larger when using conventional NPWT than when using NPWT with the protective disc (9.7 ± 1.0 cm2 vs. 1.8 ± 0.2 cm2, p &lt; 0.001, 12 hours), (14.5 ± 0.9 cm2 vs. 2.0 ± 0.2 cm2, 24 hours) (17.0 ± 0.7 cm2 vs. 2.5 ± 0.2 cm2 with the disc, p &lt; 0.001, 48 hours)<br/><br>
<br/><br>
CONCLUSIONS:<br/><br>
The areas of petechial bleeding in the small intestinal wall were significantly larger following conventional NPWT after 12, 24 and 48 hours, than using NPWT with a protective disc between the intestines and the vacuum source. The protective disc protects the intestines, reducing the amount of petechial bleeding.},
  articleno    = {10},
  author       = {Lindstedt Ingemansson, Sandra and Malmsjö, Malin and Hansson, Johan and Hlebowicz, Joanna and Ingemansson, Richard},
  issn         = {1471-2482},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {BMC Surgery},
  title        = {Macroscopic changes during negative pressure wound therapy of the open abdomen using conventional negative pressure wound therapy and NPWT with a protective disc over the intestines.},
  url          = {http://dx.doi.org/10.1186/1471-2482-11-10},
  volume       = {11},
  year         = {2011},
}