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

Lindstedt Ingemansson, Sandra LU ; Malmsjö, Malin LU ; Hansson, Johan; Hlebowicz, Joanna and Ingemansson, Richard LU (2012) In BMC Surgery 12(4).
Abstract
Background: Negative 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. Methods: Six pigs... (More)
Background: Negative 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. Methods: Six 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. Results: Abdominal 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. Conclusions: The 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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BMC Surgery
volume
12
issue
4
publisher
BioMed Central
external identifiers
  • wos:000303338600001
  • scopus:84858739738
ISSN
1471-2482
DOI
10.1186/1471-2482-12-4
language
English
LU publication?
yes
id
c1b445ef-5808-4ea5-b5bb-f2658d654b12 (old id 2570664)
date added to LUP
2012-06-01 08:51:53
date last changed
2017-11-12 03:34:40
@article{c1b445ef-5808-4ea5-b5bb-f2658d654b12,
  abstract     = {Background: Negative 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. Methods: Six 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. Results: Abdominal drainage was significantly better (p &lt; 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. Conclusions: The 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.},
  author       = {Lindstedt Ingemansson, Sandra and Malmsjö, Malin and Hansson, Johan and Hlebowicz, Joanna and Ingemansson, Richard},
  issn         = {1471-2482},
  language     = {eng},
  number       = {4},
  publisher    = {BioMed Central},
  series       = {BMC Surgery},
  title        = {Pressure transduction and fluid evacuation during conventional negative pressure wound therapy of the open abdomen and NPWT using a protective disc over the intestines},
  url          = {http://dx.doi.org/10.1186/1471-2482-12-4},
  volume       = {12},
  year         = {2012},
}