Comparative study of open abdomen treatment: ABThera™ vs. abdominal dressing™

Olona, Carles; Caro, Aleidis; Duque, Enric; Moreno, Fernando Mendoza; Vadillo, J; Rueda, Juan C.; Vicente, Vicente

doi:10.1007/s10029-014-1253-5

Cited by 17 publications

(14 citation statements)

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“…Los principales beneficios en el manejo del abdomen abierto, incluyen la prevención y tratamiento de la hipertensión intra-abdominal, síndrome compartimental, control de daños, prevención y tratamiento de fascitis, pancreatitis necrotizante y la realización de lavados peritoneales [11,12]. La decisión de realizar laparotomía es responsabilidad del cirujano ya que se deben valorar aspectos como el estado nutricional del paciente, intensidad del proceso in- feccioso y su estado hemodinámico [11].…”

Section: Discussionunclassified

“…Baker y colaboradores reportaron 15 años de experiencia usando un sistema de vacío local en 258 pacientes (116 de traumatismo y 142 de cirugía vascular); se observó un cierre primario en un 68 % de ellos, un 5 % presentó fístulas relacionadas con dehiscencias y enterotomías [12]. Perez et al, reportaron resultados similares usando terapia de presión negativa y el sistema de recambio por VAC en una serie de 37 pacientes que presentaron peritonitis severa y síndrome compartimental [13].…”

Section: Discussionunclassified

“…Olona, et al mencionaron que en un grupo de pacientes tratados con sistema de presión negativa, un 41 % de ellos tuvieron un cierre primario y fueron quienes necesitaron un menor número de días con terapia de presión negativa; solamente el 4 % de los pacientes desarrollaron fístulas entéricas [12].…”

Section: Discussionunclassified

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Caso Clínico: Manejo del Abdomen Abierto Séptico Mediante Sistema VAC

et al. 2017

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INTRODUCCIÓN:El abdomen abierto es una estrategia quirúrgica que ha permitido realizar un manejo quirúrgico de infecciones intraabdominales; una de las patologías intraabdominales que puede ser manejada como abdomen abierto es la diverticulitis. El manejo de la diverticulitis con un cuadro clínico séptico es quirúrgico y se pueden requerir de terapias que no son de aplicación frecuente.CASO CLÍNICO: Se trata de un paciente de sexo masculino de 46 años de edad que luego de ser diagnosticado con diverticulitis y tras una serie de intervenciones tuvo un desenlace con abdomen abierto, fistula biliar, ileostomía, colostomía, estado séptico y desnutrición severa. EVOLUCIÓN:El paciente fue manejando en forma integral, para el tratamiento quirúrgico se recurrió a la técnica de presión negativa (TPN) o sistema «vaccum», requirió varias cirugías para cambio del sistema vaccum y revisión de ostomías; el cierre definitivo de cavidad se realizó junto con el servicio de Cirugía Plástica. CONCLUSIÓN:El manejo adecuado del cuadro abdominal sin duda fue la clave para la recuperación del paciente, la utilización de técnicas innovadoras y con fundamento científico asegura una evolución adecuada del paciente. *DESCRIPTORES DeCS

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Caso Clínico: Manejo del Abdomen Abierto Séptico Mediante Sistema VAC

et al. 2017

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“…Generally the closure time of the wound take several weeks, with a high hospital stay rates (Olona et al 2015). …”

Section: Discussionmentioning

confidence: 99%

“…These are the main reasons for the use in selected cases of the ABBRA system: the reduction of the hospital stay (Olona et al 2015), the cost of the system, and the prevention of the ventral hernia after OA infected (Verdam et al 2011; van Hensbroek 2009; Salman et al 2014). In addition the traction provided by the ABRA system is dynamic, can continuously be adjusted, and permits both expansion and retraction without damaging the fascia (Table 1).…”

Section: Discussionmentioning

confidence: 99%

Delayed primary closure in open abdomen with stoma using dynamic closure system

et al. 2015

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BackgroundThe situation of abdominal sepsis secondary to colonic perforation sometimes forces treat the patient with multiple interventions in the open abdomen (OA) context. Correct management of OA is important to restore the patient’s clinical situation and to avoid further complications of the abdominal wall. Delayed primary closure of the abdomen using a dynamic and progressive traction is a relatively new technique for treating the OA.Case presentationWe report the case of a 50 year old woman with history of malnutrition and chronic obstructive pulmonary disease, affects for an OA after several surgical interventions. Two previous interventions (right colectomy, ileostomy and laparotomy with Bogotá bag) for disseminated peritonitis and abdominal compartment syndrome were performed. Six days after the Bogota bag the of the dynamic closure system ABRA® system was placed to delayed primary closure of the abdomen with excellent result results of the contingency of the abdominal wall.DiscussionThe most common technique in the current management of OA is the placement of vacuum-assisted closure or the use of a mesh. These systems generally require several operations to restore the integrity of the abdominal wall. However, the dynamic closure of the abdominal wall makes it possible to restore it into the same process.ConclusionsABRA system allows delayed primary closure of the abdominal wall in an OA by sepsis secondary to colonic perforation. The stoma was not a problem with this technique. The final closure of the abdomen was at 16 days after the ABRA placement. The abdominal wall has not alterations in the follow up after 3 years.

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Management of Open Abdomen After Trauma Laparotomy: A Comparative Analysis of Dynamic Fascial Traction and Negative Pressure Wound Therapy Systems

et al. 2019

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Background Management of the post‐traumatic open abdomen (OA) using negative pressure wound therapy (NPWT) alone is associated with low rates of primary fascial closure. The abdominal reapproximation anchor (ABRA) system exerts dynamic medial fascial traction and may work synergistically with NPWT to facilitate primary fascial closure. Methods Patients with an OA following trauma laparotomy between 2009 and 2018 were identified from a prospectively maintained institutional database. Patients treated with ABRA in conjunction with NPWT (ABRA) versus NPWT alone (NPWT) were compared in terms of primary fascial closure rate, number of surgeries to closure, tracheostomy duration, length of stay and incidence of entero‐atmospheric fistula. Multivariable linear regression was performed to identify predictors of tracheostomy duration. Results We identified 48 patients [ABRA, 12 and NPWT, 36]. The ABRA group was significantly younger (25 vs. 37 years, p = 0.027) and included a lower proportion of males (58% vs. 89%, p = 0.032). Groups were similar with respect to the incidence of hollow viscus injury, injury severity score and abdominal abbreviated injury score. Compared to the NPWT group, the ABRA group had a significantly higher rate of primary fascial closure (100% vs. 28%, p < 0.001), fewer surgeries to abdominal closure (2 vs. 2.5, p = 0.023) and shorter duration of tracheostomy (15.5 vs. 36 days, p = 0.008). There were no differences in length of stay or incidence of entero‐atmospheric fistula. On multivariable linear regression, ABRA placement was an independent predictor of shorter tracheostomy duration, after adjusting for covariates (β = − 0.294, p = 0.036). Conclusion For the post‐traumatic OA, ABRA coupled with NPWT achieves a higher rate of primary fascial closure compared to NPWT alone, while requiring fewer surgeries and a shorter duration of tracheostomy.

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Comparative study of open abdomen treatment: ABThera™ vs. abdominal dressing™

Abstract: Compared to the AD system, ABT can achieve faster primary closure after open abdomen treatment with only minor complications.

Cited by 17 publications

References 18 publications

Caso Clínico: Manejo del Abdomen Abierto Séptico Mediante Sistema VAC

Caso Clínico: Manejo del Abdomen Abierto Séptico Mediante Sistema VAC

Delayed primary closure in open abdomen with stoma using dynamic closure system

Management of Open Abdomen After Trauma Laparotomy: A Comparative Analysis of Dynamic Fascial Traction and Negative Pressure Wound Therapy Systems

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