Systematic review and evidence based recommendations for the use of Negative Pressure Wound Therapy in the open abdomen

Bruhin, A.; Ferreira, Fernando; Chariker, Mark; Smith, J. M.; Runkel, N.

doi:10.1016/j.ijsu.2014.08.396

Cited by 127 publications

(116 citation statements)

References 100 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…With regard to the case described above, it is probable that conventional dressings would have been unlikely to have successfully maintained an environment conducive to healing, considering the presence of a purulent fistula in contact with the prosthetic arterial graft and the large areas of dehiscence. Systematic reviews 8,9 and a randomized study 10 show the effectiveness of negative pressure dressings in a range of situations, in terms both of the proportion of wounds healed and the speed with which they close, and they are particularly effective for diabetic feet, [11][12][13] skin grafts 14 and infections after surgery. 15,16 However, there is still a lack of good quality randomized studies free from conflicts of interest that would allow the method to be evaluated more thoroughly.…”

Section: Discussionmentioning

confidence: 99%

Uso de curativo a vácuo como terapia adjuvante na cicatrização de sítio cirúrgico infectado

et al. 2017

View full text Add to dashboard Cite

Infections at the sites of surgery involving synthetic prostheses are challenging to treat. We present a case of a patient with multiple comorbidities who had undergone an aortobifemoral bypass 6 years previously and then re-intervention at the femoral anastomoses for restenosis 5 years previously. The patient presented with acute left inguinal pain and swelling and was diagnosed with a ruptured femoral pseudoaneurysm and hemodynamic instability. A repair was conducted by interposition of a silver-coated Dacron graft in the emergency room, and a large abdominal incisional hernia was repaired with synthetic mesh during the same intervention. After surgery, the patient remained intubated in intensive care for a long period. Meanwhile, she presented dehiscence of sutures and a left inguinal purulent fistula that was in contact with the vascular prosthesis. Conservative treatment was chosen, with debridement of wounds and vacuum therapy. The patient improved and the wounds healed. This could be an important tool in similar cases.Keywords: treatment; healing; abdominal injury closure techniques; infection; vascular prosthesis. ResumoInfecções de sítios cirúrgicos com envolvimento de próteses sintéticas constituem grande desafio para tratamento. Apresentamos o caso de uma paciente com múltiplas comorbidades, histórico de enxerto aortobifemoral há 6 anos e reabordagem das anastomoses femorais por reestenoses há 5 anos. Apresentou dor inguinal esquerda e abaulamento súbitos com diagnóstico de pseudoaneurisma femoral roto e instabilidade hemodinâmica. Foi submetida a correção emergencial com interposição de prótese de dácron recoberta por prata e correção de grande hérnia incisional abdominal com tela sintética ao mesmo tempo. No pós-operatório, manteve-se por longo período sob terapia intensiva com dificuldade de extubação. Nesse ínterim, apresentou deiscência das suturas e fístula purulenta inguinal esquerda em contato com a prótese vascular. Optou-se pelo tratamento conservador, com desbridamento das feridas e aplicação de curativo a vácuo. A paciente evoluiu com melhora e cicatrização das feridas. Essa pode se constituir em ferramenta importante em casos similares.Palavras-chave: terapêutica; cicatrização; técnicas de fechamento de ferimentos abdominais; infecção; prótese vascular.

show abstract

Section: Discussionmentioning

confidence: 99%

Uso de curativo a vácuo como terapia adjuvante na cicatrização de sítio cirúrgico infectado

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Es un método eficaz, de simple ejecución, que permite un rápido acceso a la cavidad abdominal [91][92][93][97][98][99][100][101][102][103][106][107][108][111][112][113][114] . Además, algunas prótesis pueden quedar en el lugar del implante primario e incorporarse a los tejidos favoreciendo el cierre definitivo.…”

Section: Materiales Sintéticos O Biológicosunclassified

Manejo Del Abdomen Abierto: Desde La Operación Inicial Al Cierre Definitivo

Latif¹

2017

Rev Argent Cirug

View full text Add to dashboard Cite

“…Assessment of the presence of the fistula, successful closure 5 Wound closure in 7 days 6 Wound closure in 10 days 7 Wound closure in 30 days 8 Over 30 days after the end of hospitalization 4 Wound closure in 7 days 5 Wound closure in 10 days 6 Wound closure in 30 days 7 Over 30 days after the end of hospitalization 6 successful closure of the fistula (primary or resection) 7 successful diversion of the fistula content 8 unsuccessful diversion of the fistula content of the fistula, successful diversion of the fistula, and their stratification based on the indication is shown in the Table VII. Mortality rate of the patients with fistulas is shown in the Table VIII.…”

Section: Frommentioning

confidence: 99%

“…3,4 Because of high variability and relatively small numbers of patients, assessment in terms of evidence based medicine (EBM) is rather uneasy. Pursuit of recommendations based on literary metanalysis 5 is complicated and numerous recommendations are of level B, C, and D by SIGN metodology. 6 In our previous paper, we proved statistically significant decrease of mortality by 27.64% in patient with OA, managed by NPWT vs. conventional TAC (64.71% vs. 37.04%, p = 0.0256) 7 and proved statistically significantly higher success of local management of EAF, if NPWT was used.…”

mentioning

confidence: 99%

Prospective Assessment of the Negative Pressure Wound Therapy of the Open Abdomen

Bartko

Prochotský

Sekac

et al. 2016

NPWTJ

View full text Add to dashboard Cite

Abstract-Open abdomen (OA) is a surgical approach, that emerged in last 15 years, with its management being complicated, timely and financially demanding, burdened with high morbidity and mortality. In recent years, several publications proved superiority of usage of negative pressure wound therapy (NPWT) over usage of conventional temporary abdominal closure techniques in treatment of open abdomen. Different aspects of treatment of OA with NPWT remain to be assessed and stated.Authors of the paper prospectively assessed group of 48 patients with OA, managed by one surgeon with NPWT between 2006-2014, assessing mortality and morbidity in the group stratified by indication for OA, type of sequential closure of OA, presence and management of concomitant enteroatmospheric fistula (EAF), maximal values of C-reactive protein (CRP) and Procalcitonine (PCT), and initial body mass index (BMI).Mortality of the whole group was 35.41%, rate of fascial closure 45.83% and rate of the wound closure 83.33%. Incidence of the fistula was 37.5%, of these 66.67% were successfully locally managed. Incidence of fascial closure without use of sequential closure was significantly lower as opposed to use of different techniques of sequential closure. Unsuccessful local management of EAF is significant predictor of mortality. All other data were not found to be statistically significant.Identifying specific aspects of treatment of OA by NPWT, significantly improving outcomes, and adhering to these aspects in clinical practice will further ameliorate outcomes.

show abstract

Systematic review and evidence based recommendations for the use of Negative Pressure Wound Therapy in the open abdomen

Abstract: The most efficient temporary abdominal closure techniques are NPWT kits with or without a dynamic closure procedure. Evidence-based recommendations will help to tailor its use in a complex treatment pathway for the individual patient.

Cited by 127 publications

References 100 publications

Uso de curativo a vácuo como terapia adjuvante na cicatrização de sítio cirúrgico infectado

Uso de curativo a vácuo como terapia adjuvante na cicatrização de sítio cirúrgico infectado

Manejo Del Abdomen Abierto: Desde La Operación Inicial Al Cierre Definitivo

Prospective Assessment of the Negative Pressure Wound Therapy of the Open Abdomen

Contact Info

Product

Resources

About