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Microvascular Blood Flow Changes in the Small Intestinal Wall During Conventional Negative Pressure Wound Therapy and Negative Pressure Wound Therapy Using a Protective Disc Over the Intestines in Laparostomy.

Lindstedt Ingemansson, Sandra LU ; Malmsjö, Malin LU ; Hansson, Johan; Hlebowicz, Joanna LU and Ingemansson, Richard LU (2012) In Annals of Surgery 255. p.171-175
Abstract
OBJECTIVES:: Blood flow changes in the intestines during conventional negative pressure wound therapy (NPWT), and NPWT using a protective disc over the intestines in laparostomy. BACKGROUND:: Higher closure rates of the open abdomen have been reported with NPWT compared with other kinds of wound management. However, the method has been associated with increased development of fistulae. We have compared the changes in blood flow in the intestinal wall using conventional NPWT and NWPT with a protective disc between the intestines and the vacuum source. METHODS:: Midline incisions were made in 10 pigs and either conventional NPWT or NPWT with a disc over the intestines was applied. The microvascular blood flow was measured in the intestinal... (More)
OBJECTIVES:: Blood flow changes in the intestines during conventional negative pressure wound therapy (NPWT), and NPWT using a protective disc over the intestines in laparostomy. BACKGROUND:: Higher closure rates of the open abdomen have been reported with NPWT compared with other kinds of wound management. However, the method has been associated with increased development of fistulae. We have compared the changes in blood flow in the intestinal wall using conventional NPWT and NWPT with a protective disc between the intestines and the vacuum source. METHODS:: Midline incisions were made in 10 pigs and either conventional NPWT or NPWT with a disc over the intestines was applied. The microvascular blood flow was measured in the intestinal wall before and after the application of topical negative pressures of -50, -70, and -120 mmHg, using laser Doppler velocimetry. RESULTS:: The blood flow was significantly decreased (by 24%) after the application of conventional NPWT at -50 mmHg, compared with a slight decrease (2%) after the application of NWPT with a protective disc (P < 0.05). The blood flow was significantly decreased (by 54%) after the application of conventional NPWT at -120 mmHg, compared with a slight decrease (17%) after application of NPWT using a protective disc (P < 0.001). CONCLUSIONS:: Inserting a disc between the intestines and the vacuum source in NPWT protects the intestines from ischemia. The decreased blood flow in the intestinal wall may induce ischemia, which could promote the development of intestinal fistulae. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of Surgery
volume
255
pages
171 - 175
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000298638900026
  • pmid:22104565
  • scopus:84155165486
ISSN
1528-1140
DOI
10.1097/SLA.0b013e31823c9ffa
language
English
LU publication?
yes
id
720f0f35-60bf-46e9-9ca4-39d414daeea6 (old id 2220558)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22104565?dopt=Abstract
date added to LUP
2011-12-03 09:18:25
date last changed
2017-08-20 04:35:41
@article{720f0f35-60bf-46e9-9ca4-39d414daeea6,
  abstract     = {OBJECTIVES:: Blood flow changes in the intestines during conventional negative pressure wound therapy (NPWT), and NPWT using a protective disc over the intestines in laparostomy. BACKGROUND:: Higher closure rates of the open abdomen have been reported with NPWT compared with other kinds of wound management. However, the method has been associated with increased development of fistulae. We have compared the changes in blood flow in the intestinal wall using conventional NPWT and NWPT with a protective disc between the intestines and the vacuum source. METHODS:: Midline incisions were made in 10 pigs and either conventional NPWT or NPWT with a disc over the intestines was applied. The microvascular blood flow was measured in the intestinal wall before and after the application of topical negative pressures of -50, -70, and -120 mmHg, using laser Doppler velocimetry. RESULTS:: The blood flow was significantly decreased (by 24%) after the application of conventional NPWT at -50 mmHg, compared with a slight decrease (2%) after the application of NWPT with a protective disc (P &lt; 0.05). The blood flow was significantly decreased (by 54%) after the application of conventional NPWT at -120 mmHg, compared with a slight decrease (17%) after application of NPWT using a protective disc (P &lt; 0.001). CONCLUSIONS:: Inserting a disc between the intestines and the vacuum source in NPWT protects the intestines from ischemia. The decreased blood flow in the intestinal wall may induce ischemia, which could promote the development of intestinal fistulae.},
  author       = {Lindstedt Ingemansson, Sandra and Malmsjö, Malin and Hansson, Johan and Hlebowicz, Joanna and Ingemansson, Richard},
  issn         = {1528-1140},
  language     = {eng},
  pages        = {171--175},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Annals of Surgery},
  title        = {Microvascular Blood Flow Changes in the Small Intestinal Wall During Conventional Negative Pressure Wound Therapy and Negative Pressure Wound Therapy Using a Protective Disc Over the Intestines in Laparostomy.},
  url          = {http://dx.doi.org/10.1097/SLA.0b013e31823c9ffa},
  volume       = {255},
  year         = {2012},
}