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2015 | 87 | 1 | 22-30
Tytuł artykułu

Comparison of the Effectiveness of the Treatment Using Standard Methods and Negative Pressure Wound Therapy (NPWT) in Patients Treated with Open Abdomen Technique

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Open abdomen technique is a surgical treatment in which the fascia and skin are left open in order to reduce the value of the intra-abdominal pressure. According to the World Society of the Abdominal Compartment Syndrome (WSACS) normal values of the intra-abdominal pressure are between 5 and 7 mm Hg. Intra-abdominal hypertension occurs when the pressure value is equal to or exceeds 12 mm Hg. The aim of the study was to compare the results of the open abdomen treatment using standard methods and negative pressure wound therapy. Material and methods. The study was in the form of a retrospective analysis of the documentation of the patients treated with open abdomen technique. The study included 37 patients treated in the Department of General and Endocrine Surgery and Gastroenterological Oncology and in the Department of Anesthesiology and Intensive Care of the Medical Sciences since 2009-2012. Patients were divided into two groups: group 1 (n = 20) was treated with standard surgical procedures (laparostomy, repeated peritoneal cavity lavage) and group 2 (n =17) was treated using negative pressure wound therapy (NPWT). The analysed clinical data included the period of hospitalization and clinical outcome (survival vs death), the occurrence of enteroatmospheric fistulae, cyclical determination of the quantitative C-reactive protein levels. Results. The number of deaths during hospitalization in the group treated with NPWT was lower than in the group treated with standard methods (3 vs 9). The number of fistulae during hospitalization in the group treated with NPWT dropped as compared to the group treated using standard procedures (18% vs 70%). The decrease in the CRP levels was recorded in the group treated with NPWT and its increase - in the group treated with standard methods. Conclusions. The use of NPWT in patients requiring open abdomen treatment is reasonable due to the positive results with respect to survival rates and the decrease in the number of gastrointestinal fistulae. It is necessary to train the physicians in using this type of therapy in the form of workshops and in the clinical setting.
Wydawca

Rocznik
Tom
87
Numer
1
Strony
22-30
Opis fizyczny
Daty
otrzymano
2014-07-17
online
2015-03-01
Twórcy
  • Department of General and Endocrine Surgery and Gastroenterological Oncology, Poznań University of Medical Sciences Kierownik: prof. dr hab. M. Drews, krzysztof.szmyt@gmail.com
  • Department of General and Endocrine Surgery and Gastroenterological Oncology, Poznań University of Medical Sciences Kierownik: prof. dr hab. M. Drews
  • Department of General and Endocrine Surgery and Gastroenterological Oncology, Poznań University of Medical Sciences Kierownik: prof. dr hab. M. Drews
  • Department of Surgery, Independent Public Healthcare Institution, Grodzisk Wielkopolski Ordynator: lek. A. Wach
  • Department of Surgery, Independent Public Healthcare Institution, Grodzisk Wielkopolski Ordynator: lek. A. Wach
  • Department of Anesthesiology and Intensive Care, Poznań University of Medical Sciences Kierownik: prof. dr hab. L. Drobnik
  • Department of Anesthesiology and Intensive Care, Poznań University of Medical Sciences Kierownik: prof. dr hab. L. Drobnik
  • Department of General and Endocrine Surgery and Gastroenterological Oncology, Poznań University of Medical Sciences Kierownik: prof. dr hab. M. Drews
  • Department of Surgery, Independent Public Healthcare Institution, Grodzisk Wielkopolski Ordynator: lek. A. Wach
Bibliografia
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  • 3. Diaz JJ, Cullinane DC, Dutton WD et al.: The management of the open ab̚domen in trauma and emergency general surgery: part 1-damage control. J Trauma 2010; 68(6): 1425-38.
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  • 5. Cheatham ML, Malbrain ML, Kirkpatrick A et al.: Results from the International Conference of Experts on Intra-abdominal Hypertension and Abdominal Compartment Syndrome. II. Recommendations. Int Care Med 2007; 33: 951.
  • 6. Terzi C, Egeli T, Canda AE, Arslan NC: Management of enteroatmospheric fistulae. Int Wound J 2014; 11 (Suppl 1): 17-21.[WoS]
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  • 8. Hutan JM, Hutan MS, Skultety J et al.: Use of intraabdominal VAC (Vacuum Assisted Closure) lowers mortality and morbidity in patients with open abdomen. Bratisl Lek Listy 2013; 114(8): 451-54.
  • 9. Ozer MT, Sinan H, Zeybek N, Peker Y: A simple novel technique for enteroatmospheric fistulae: silicone fistula plug. Int Wound J 2014; 11 (Suppl1): 22-24.[WoS]
  • 10. Hutan M, Banasiewicz T, Veverkova L et al.: Use of Negative Pressure Wound Therapy in Treatment of Enteroatmospheric Fistulas: Critical Review of the Literature. NPWT 2014; 1(1):10-16.
  • 11. Bobkiewicz A, Banasiewicz T, Paszkowski J, Drews M: Biliary- Cutaneous and Entero-Cutaneous Fistulas Associated with Extensive Abdominal Wound Following Blunt Abdominal Trauma Treated with Negative Pressure Wound Therapy (NPWT). NPWT 2014; 1(1):22-26; www.researchpub. org/journal/npwt/npwt.html
  • 12. Jannasch O, Lippert H, Tautenhahn J: A novel device for treating enteroatmospheric fistulae in the open abdomen. Zentralbl Chir 2011 Dec; 136(6):585-89.[WoS]
  • 13. Hougaard HT, Ellebaek M, Holst UT, Qvist N: The open abdomen: temporary closure with a modified negative pressure therapy technique. Int Wound J 2014; 11 (Suppl 1): 13-16.
  • 14. W ild T, Staettner S, Lechner P et al.: Experience with Negative Pressure Therapy in Temporary Abdominal Closure of Patients with Secondary Peritonitis. NPWT 2014; 1(2): 33-38; www.researchpub.org/journal/npwt/npwt.html.
  • 15. Banasiewicz T, Cybuł1;ka B, Iqbal A et al.: Clinical and Economic Benefit of Negative Pressure Wound Therapy in Treatment of the Open Abdomen. NPWT 2014; 1(2): 39-47; www.researchpub.org/journal/npwt/npwt.html.
  • 16. C ambau E: C-reactive protein: general review and role in the study of infections. Pathol Biol(Paris) 1988; 36(10): 1232-36.
  • 17. Hallan S, Asberg A: The accuracy of C-reactive protein in diagnosing acute appendicitis a metaanalysis. Scand J Clin Lab Invest 1997; 57(5):373-80.[Crossref]
  • 18. de Wit NJ, Berger MY, Vogelenzang R et al.: Summary of the Dutch College of General Practitioners (NHG) practice guideline on 'Diverticulitis'. Ned Tijdschr Geneeskd 2012; 156(5): A4140.
  • 19. van Esch S, Krediet RT, Struijk DG: Prognostic factors for peritonitis outcome. Contrib Nephrol 2012; 178: 264-70.
  • 20. Vaughan-Shaw PG, Rees JR, King AT: Neutrophil lymphocyte ratio in outcome prediction after emergency abdominal surgery in the elderly. Int J Surg 2012; 10(3): 157-62.[Crossref][WoS]
  • 21. Banasiewicz T, Drews M: Negative Pressure Wound Therapy (NPWT) in Open Abdomen - An Animal Model for Surgeons Training. NPWT 2014;1(2): 48-53; www.researchpub.org/journal/npwt/npwt.html.
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_1515_pjs-2015-0013
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