The Use of Vacuum-Assisted Closure in the Management of Septic Peritonitis in Six Dogs

Abstract

The purpose of this study was to describe the appropriate surgical technique, postoperative monitoring, and complications encountered with use of vacuum-assisted closure (VAC) in six dogs with confirmed septic peritonitis. Initial diagnosis of septic peritonitis was performed by measuring either the blood-to-fluid lactate ratio and glucose concentration differences or cytologic verification of intracellular bacteria. After appropriate surgical procedures were performed to manage the primary cause of peritoneal sepsis, a VAC was performed. Serum and abdominal fluid protein levels were measured, and all complications were noted during the postoperative period. Three of the six dogs (50%) survived to the secondary closure and were subsequent discharged, which is similar to previous studies where the abdomen was either closed primarily or treated with open abdominal drainage. No major complications occurred with bandage management during hospitalization. The results of this study support VAC as a feasible technique for managing septic peritonitis.

Evaluation of Data From 35 Dogs Pertaining to Dehiscence Following Intestinal Resection and Anastomosis

“…It is also possible that there was a selection bias, with more significant abdominal pathology leading to the decision to place a drain, regardless of ultimate survival or death.A recent study evaluated vacuum assisted closure after surgery on dogs with septic abdomens. Although there were only three surviving patients, it is interesting to note that their blood to abdominal fluid glucose and lactate differences improved to within normal values within 2 days postoperatively 25. The values were most similar to those of the patients in the NDNCS group, Dehiscence Following Intestinal Resection and Anastomosis all of which had "normal" differences between their serum and fluid lactate and glucose at 24 and 48 hr.…”

“…Closure techniques include closed suction drains, open abdominal drainage, sump Penrose drainage, planned abdominal re-exploration, and vacuum-assisted closure, which has had some success in human medicine. 10,23-26So far, results showing one closure method as superior to another has been lacking 10,23,25,27. It is unclear how the presence or absence of a drain affects the intra-abdominal environment.In the current study, there were significant differences in blood to fluid glucose and lactate between patients that survived with and without a Jackson-Pratt drain, with patients without drains having lower differences, or "more normal" values, at both 24 and 48 hr.…”

Current Concepts in Negative Pressure Wound Therapy

“…Laparostomy NPWT, or open-abdomen NPWT, has been used successfully in human patients with septic peritonitis and has also been reported in veterinary medicine. 46,47,49,50,84,85 With laparostomy NPWT in humans, a special foam for abdominal usage (ABThera Open Abdomen Negative Pressure Therapy, KCI, Inc) is attached to visceral protective sheeting and inserted into the abdomen, making certain that the foam fingers are slid along the sides of the inner abdominal walls and rest deeply into the dorsal recesses of the abdominal cavity. The special usage foam is covered with a Tegaderm sheet and attached to the vacuum unit in a standard manner.…”

Barium Peritonitis in Small Animals

“…Closed suction drainage, open peritoneal drainage or vacuum-assisted drainage can be utilized for small animal barium peritonitis cases [9, 12, 32, 35, 41, 48, 60]. If significant postoperative abdominal fluid production is anticipated, the surgeon must consider which abdominal drainage technique is appropriate.…”