Prognostic Factors for Enteroatmospheric Fistula in Open Abdomen Treated with Negative Pressure Wound Therapy: a Multicentre Experience

2017 ◽  
Vol 21 (8) ◽  
pp. 1328-1334 ◽  
Author(s):  
Guillaume Giudicelli ◽  
A. Rossetti ◽  
C. Scarpa ◽  
N. C. Buchs ◽  
R. Hompes ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Open Abdomen ◽  
Wound Therapy ◽  
Enteroatmospheric Fistula

The Use Of Negative Pressure Wound Therapy (NPWT) In The Management Of Enteroatmospheric Fistula – Case Report And Literature Review

2015 ◽  
Vol 87 (10) ◽  
Author(s):  
Rajmund Jaguścik ◽  
Dominik A. Walczak ◽  
Joanna Porzeżyńska ◽  
Piotr W. Trzeciak
Keyword(s):  
Negative Pressure ◽  
Metabolic Disorders ◽  
Multidisciplinary Approach ◽  
Negative Pressure Wound Therapy ◽  
Open Abdomen ◽  
Oral Intake ◽  
Surgical Team ◽  
Wound Therapy ◽  
Necrotic Pancreatitis ◽  
Enteroatmospheric Fistula

AbstractAn enteric fistula that occurs in an open abdomen is called an enteroatmospheric fistula (EAF) and is the most challenging complication for a surgical team to deal with. The treatment of EAF requires a multidisciplinary approach. First of all, sepsis has to be managed. Any fluid, electrolyte and metabolic disorders need to be corrected. Oral intake must be stopped and total parenteral nutrition introduced. The control and drainage of the effluent from the fistula is a separate issue. Since there are no fixed algorithms for the treatment of EAF, surgeons need to develop their own, often highly unconventional solutions.We present the case of a 24-year-old man who developed enteroatmospheric fistula after laparotomy and relaparotomy due to acute necrotic pancreatitis. Both the laparostomy and the fistula were successfully managed using modified negative pressure wound therapy. The literature regarding this issue was also reviewed.

scholarly journals Management of enteroatmospheric fistula with negative pressure wound therapy in open abdomen treatment: a multicentre observational study

2016 ◽  
Vol 14 (1) ◽  
pp. 255-264 ◽  
Author(s):  
Adam Bobkiewicz ◽  
Dominik Walczak ◽  
Szymon Smoliński ◽  
Tomasz Kasprzyk ◽  
Adam Studniarek ◽  
...  
Keyword(s):  
Observational Study ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Open Abdomen ◽  
Wound Therapy ◽  
Enteroatmospheric Fistula

Treatment of Enterotmospheric Fistulas in the Open Abdomen Management Using Negative Pressure Wound Therapy. A Multicenter Observational Study

2017 ◽  
Vol 152 (5) ◽  
pp. S1244-S1245
Author(s):  
Adam Bobkiewicz ◽  
Dominik Walczak ◽  
Adam Studniarek ◽  
Jacek Szmeja ◽  
Tomasz Banasiewicz
Keyword(s):  
Observational Study ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Open Abdomen ◽  
Wound Therapy ◽  
Multicenter Observational Study

scholarly journals Successful Use of Negative Pressure Wound Therapy for Abdominal Wall Necrosis Caused by a Perforated Ascending Colon Using the ABThera System

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Kouki Imaoka ◽  
Takuya Yano ◽  
Yasuhiro Choda ◽  
Ko Oshita ◽  
Yuma Tani ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Open Abdomen ◽  
Anterolateral Thigh Flap ◽  
Temporary Abdominal Closure ◽  
Ascending Colon ◽  
Wound Therapy ◽  
Pressure Therapy ◽  
New Device

Background. The practice of leaving the abdomen open after an emergency laparotomy has gained increasing popularity recently. Negative pressure wound therapy (NPWT) is known as an effective technique in the management of an open abdomen (OA). A new device, the ABThera™ Open Abdomen Negative Pressure Therapy System (KCI USA, San Antonio, TX, USA), was specifically designed to achieve a temporary abdominal closure (TAC) in the management of an OA. This study was aimed at presenting a successful experience of treating a case of abdominal wall necrosis caused by a perforated ascending colon using the ABThera System. Case Presentation. A 66-year-old man was admitted to our hospital with complaints of severe pain in the abdomen. On admission, abdominal contrast-enhanced computed tomography (CT) showed fluid collection, an air pocket in the subcutaneous fat layer of the abdominal wall, and edematous changes in the adipose tissue in the peritoneum and abdominal wall. Based on a diagnosis of peritonitis resulting from a perforated ascending colon, emergency surgery was performed. A right hemicolectomy, ileostomy construction, and debridement of the necrotic tissues were performed. However, necrotizing fasciitis rapidly spread; therefore, more necrotic tissue was debrided in a second operation. The abdominal wall defect was left open, and the ABThera System was used in the management of the OA; this device promoted wound healing. A reduction was observed in the size of the open wound with visible granulation tissue. The defect was finally covered with a mesh split-thickness skin graft and anterolateral thigh flap. Conclusions. In the management of a case of a massive wound with infection, it can be of great benefit to treat the wound with NPWT initially to decrease its size. The ABThera System could facilitate early and safe management of an OA by surgeons.

Delayed closure of open abdomen in septic patients is facilitated by combined negative pressure wound therapy and dynamic fascial suture

2013 ◽  
Vol 28 (3) ◽  
pp. 735-740 ◽  
Author(s):  
René H. Fortelny ◽  
Anna Hofmann ◽  
Simone Gruber-Blum ◽  
Alexander H. Petter-Puchner ◽  
Karl S. Glaser
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Open Abdomen ◽  
Wound Therapy ◽  
Delayed Closure

scholarly journals Greater Success of Primary Fascial Closure of the Open Abdomen: A Retrospective Study Analyzing Applied Surgical Techniques, Success of Fascial Closure, and Variables Affecting the Results

2016 ◽  
Vol 106 (2) ◽  
pp. 145-151 ◽  
Author(s):  
M. Kääriäinen ◽  
M. Kuuskeri ◽  
M. Helminen ◽  
H. Kuokkanen
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Open Abdomen ◽  
Component Separation ◽  
Separation Technique ◽  
Fascial Closure ◽  
Study Patient ◽  
Wound Therapy ◽  
Closure Rate ◽  
Component Separation Technique

Background and Aims: The open abdomen technique is a standard procedure in the treatment of intra-abdominal catastrophe. Achieving primary abdominal closure within the initial hospitalization is a main objective. This study aimed to analyze the success of closure rate and the effect of negative pressure wound therapy, mesh-mediated medial traction, and component separation on the results. We present the treatment algorithm used in our institution in open abdomen situations based on these findings. Material and Methods: Open abdomen patients (n = 61) treated in Tampere University Hospital from May 2005 until October 2013 were included in the study. Patient characteristics, treatment prior to closure, closure technique, and results were retrospectively collected and analyzed. The first group included patients in whom direct or bridged fascial closure was achieved, and the second group included those in whom only the skin was closed or a free skin graft was used. Background variables and variables related to surgery were compared between groups. Results and Conclusion: Most of the open abdomen patients (72.1%) underwent fascial defect repair during the primary hospitalization, and 70.5% of them underwent direct fascial closure. Negative pressure wound therapy was used as a temporary closure method for 86.9% of the patients. Negative pressure wound therapy combined with mesh-mediated medial traction resulted in the shortest open abdomen time (p = 0.039) and the highest fascial repair rate (p = 0.000) compared to negative pressure wound therapy only or no negative pressure wound therapy. The component separation technique was used for 11 patients; direct fascial closure was achieved in 5 and fascial repair by bridging the defect with mesh was achieved in 6. A total of 8 of 37 (21.6%) patients with mesh repair had a mesh infection. The negative pressure wound therapy combined with mesh-mediated medial traction promotes definitive fascial closure with a high closure rate and a shortened open abdomen time. The component separation technique can be used to facilitate fascial repair but it does not guarantee direct fascial closure in open abdomen patients.

scholarly journals Negative pressure wound therapy: the past and the future

2017 ◽  
Vol 86 (3) ◽  
pp. 127-135
Author(s):  
M. L. Go ◽  
M. Or ◽  
B. Van Goethem ◽  
A. Kitshoff ◽  
E. Abma ◽  
...  
Keyword(s):  
Veterinary Medicine ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Open Abdomen ◽  
Human Medicine ◽  
Wound Therapy ◽  
Positive Effects ◽  
The Past ◽  
New Methods ◽  
Partial Thickness Burns

Negative pressure wound therapy (NPWT) involves the application of negative pressure on a wound bed for its positive effects on wound healing. Indications for NPWT concern various types of wounds, skin grafts and flaps, partial-thickness burns, open abdomen management and closed incisions. Negative pressure wound therapy has been used for centuries in human medicine. Its first use dates back to the Roman era (around 27 BCE) when human generated pressures were used. Later, European and Russian physicians developed various advanced methods and systems to apply negative pressure on wounds or other injuries. The on-going positive findings in human medicine triggered researchers in veterinary medicine to apply this technique on animal patients. However, much still has to be investigated regarding NPWT, especially in veterinary medicine, as there are many factors playing a role in the mechanisms of this treatment. New methods and techniques are continuously being developed and the existing studies show great potential for NPWT.

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