Evaluating the effects of immediate application of negative pressure therapy after decompression from abdominal compartment syndrome in an experimental porcine model

The abdominal vacuum-assisted closure (VAC) system has been introduced, providing a new possibility to treat an open abdomen. Abdominal compartment syndrome has a great relevance in surgical practice and patient care in critical condition due to the effects of increased pressure in the enclosed space of the abdomen can lead to multiple organ failure. A prospective study was conducted on a sample of 15 patients with severe acute pancreatitis (SAP) was retrospectively analyzed, following the incidence of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS),the effectiveness of the therapeutic methods applied in reducing the intra-abdominal pressure (PIA), the evolution of severity scores, lenght of stay in intensive care unit between January 2014 - March 2017, following negative pressure therapy. There were used vacuum assisted closure devices (VAC � -Hartman) in order to apply negative pressure to the open abdomen, while complying with specified settings in accordance with patients� outcome. Surgery for abdominal decompression in PAS with SCA is an emergency and was imposed on 14 of the 15 patients . In the studied group, the first decompression procedure was performed on days 2 to 5 from intake, as PIA increased in evolution despite medical methods. Only 1 patient hospitalized with SAP PIA decreased by medical methods and after haemofiltration. Acute severe pancreatitis remains a serious pathology in spite of a maximum medical and surgical therapy.Continuous venous haemofiltration has contributed to lowering intraabdominal pressure. Surgery with decompression vacuum systems with negative pressure lead to a significant decrease in PIA.

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Pressure Distribution during Negative Pressure Wound Therapy of Experimental Abdominal Compartment Syndrome in a Porcine Model

10.20944/preprints201801.0100.v1 ◽

2018 ◽

Author(s):

Adrienn Csiszkó ◽

Klaudia Balog ◽

Zoltán Attila Godó ◽

Gyula Juhász ◽

Katalin Pető ◽

...

Keyword(s):

Pressure Distribution ◽

Compartment Syndrome ◽

Abdominal Compartment Syndrome ◽

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Porcine Model ◽

Abdominal Cavity ◽

Absolute Pressure ◽

Wound Therapy ◽

Abdominal Compartment

1) Introduction: Negative pressure wound therapy (NPWT) is a frequently applied open abdomen (OA) treatment. There are only a few experimental data supporting this method and describing the optimal settings and pressure distribution in the abdominal cavity during this procedure. The aim of our study was to evaluate pressure values at different points of the abdominal cavity during NPWT in experimental abdominal compartment syndrome (ACS) animal model. 2) Methods: In this study (permission Nr. 13/2014/UDCAR) 27 Hungahib pigs (15.4- 20.2 kg) were operated. ACS was generated by implanting a plastic bag in the abdomen through mini-laparotomy and filled with 2100- 3300 ml saline solution (37 C°) to an intraabdominal pressure (IAP) of 30 mmHg. After 3 hours, NPWT (Vivano Med ® Abdominal Kit, Paul Hartmann AG, Germany) or Bogota bag was applied. NPWT group was divided into -50, -100 and 150 mmHg suction group. Pressure distribution to the abdominal cavity was monitored at 6 different points of the abdomen via a multichannel pressure monitoring system. 3) Results: The absolute pressure levels were significantly higher above than below the layer. The values of the pressure were similar in the midline than laterally. Amongst the bowels, the pressure values changed periodically between 0 and -12 mmHg which might be caused by the peristaltic movements. 4) Conclusions: The porcine model of the present study seems to be well applicable for investigating ACS and NPWT. It was possible to provide valuable for clinicians. The pressure was well distributed by the protective layer to the lateral parts of the abdomen and this phenomenon did not change considerably during the therapy.

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