Discussion: Low Complication Rates Using Closed-Incision Negative-Pressure Therapy for Panniculectomies: A Single-Surgeon, Retrospective, Uncontrolled Case Series

Abstract Background and study aims Endoscopic negative pressure therapy (ENPT) has been developed to treat gastrointestinal leakages. Up to now, ENPT has usually been performed with open-pore polyurethane foam drains (OPD). A big disadvantage of the OPDs is their large diameter. We have developed a new, small-bore open-pore film drainage (OFD). Herein we report our first experience in a case series of 16 patients. Patients and methods OFD is constructed with a drainage tube and a very thin double-layered open-pore drainage film (Suprasorb CNP, Drainage Film, Lohmann & Rauscher International, Germany). The distal end of the tube is wrapped with only one layer of film. OFD is placed into the gastrointestinal leakage site with common endoscopic techniques. The tube is connected to an electronic vacuum device and continuous negative pressure of –125 mmHg applied. Results From 2013 to 2016, 16 patients were treated with the new OFD device. In 10 patients, transmural intestinal defects (4 esophageal, 4 rectum/colon, 1 duodenal, 1 pancreatic cyst) were closed with ENPT in median time of 12 days (range 3 – 34 days). Five of the 10 patients were treated solely with OFD devices. In five patients ENPT started with ODP and changed to OFD when the cavity was shrunken to a channel with a small opening. In four patients postoperative gastric reflux was eliminated for 5 to 16 days. Conclusions Small-bore OFD opens up promising new treatment options within ENPT. OFD can be used in endoscopic closure management of intestinal leakages in the upper and lower gastrointestinal tract. Gastric reflux can be eliminated in an active manner. OFD can be inserted nasally. OFD may be an adequate substitute for OPD, especially when placement of the larger OPD is difficult.Meeting presentations: The authorsʼ experience was first reported in an oral presentation at the 46th Kongress der Deutschen Gesellschaft für Endoskopie und Bildgebende Verfahren in Mannheim (DGE-BV), 17. – 19.03.2016.

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Combined Endoscopic Negative Pressure and Surgical Treatment of Anastomotic Insufficiencies following Oncological Gastrectomy – Recent Results

10.21203/rs.3.rs-39681/v1 ◽

2020 ◽

Author(s):

Doerte Wichmann ◽

Dietmar Stüker ◽

Karolin Thiel ◽

Jessica Lange ◽

Ulrike Schempf ◽

...

Keyword(s):

Negative Pressure ◽

Case Series ◽

Anastomotic Dehiscence ◽

Time Interval ◽

Leakage Detection ◽

Negative Pressure Therapy ◽

Pressure Therapy ◽

Related Data ◽

First Line Therapy ◽

Limited Surgery

Abstract Background and study aims: Management of esophago-jejunal anastomotic leakages (EJAL) following gastrectomy is challenging. Endoscopic negative pressure therapy (ENPT) is an emerging effective tool for treatment of gastrointestinal and anastomotic leaks. We have been using ENPT as first line therapy for EJAL after oncological gastric resections since 2018. The aim of the study was to present our results with this strategy in a case series. Methods: Nine consecutive patients were treated with ENPT for EJAL after oncological gastrectomy between 01.2018 and 12.2019. A retrospective analysis of patients’ and treatment-related data was performed. Results: Time to leakage detection was 6.00 ± 2.49 days after surgery. After 14.78 ± 9.66 days of ENPT, 6.25 ± 3.65 endoscopies and 38.11 ± 16.46 days of hospitalization, endoscopic treatment with ENPT combined with surgical debridement and drainage for sepsis control was effective in eight of nine patients. In one patient with a complete anastomotic dehiscence, treatment was changed to a stent-based therapy combined with surgery. Conclusions: ENPT is a new and promising option in the complication management of patients with anastomotic insufficiencies following oncological gastrectomy. It can be recommended in combination with limited surgery to preserve the anastomosis and provide sepsis control. The time interval to diagnosis and the size of the insufficiency are important for the success of ENPT in patients with EJAL.

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Large abdominal hernia repair with closed incision negative pressure therapy: a case series

Journal of Wound Care ◽

10.12968/jowc.2021.30.3.192 ◽

2021 ◽

Vol 30 (3) ◽

pp. 192-196

Author(s):

Edward Wang ◽

Leigh Archer ◽

Amanda Foster ◽

Mohammed Ballal

Keyword(s):

Incisional Hernia ◽

Hernia Repair ◽

Negative Pressure ◽

Case Series ◽

Incisional Hernia Repair ◽

Abdominal Hernia ◽

Wound Complications ◽

Control Group ◽

Negative Pressure Therapy ◽

Pressure Therapy

Objective: A major challenge of large abdominal incisional hernia repair is the high rates of wound complications. Closed incision negative pressure therapy (CINPT) can offer many treatment advantages in the management of these wounds and has been shown to reduce complications for other postoperative incisions. This study assesses the wound outcomes for hernia repair patients receiving CINPT. Method: A six-year retrospective case series of patients who had undergone large abdominal incisional hernia repair wounds treated with CINPT was conducted. Outcomes for patients treated with CINPT were compared with patients who had not received CINPT acting as a control. Results: A total of 23 patients were treated with CINPT after hernia repair and compared with 12 patients in the control group. A statistically significant decreased rate of return to theatre (odds ratio: 0.12) was found in this study. Non-significant reductions in wound infection, seroma and wound dehiscence were also seen. No adverse events with CINPT therapy were reported. Conclusions: CINPT, when used after large abdominal incisional hernia repair, may help in the prevention of wound complications.

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Negative pressure therapy (vacuum) for wound bed preparation among diabetic patients: case series

Sao Paulo Medical Journal ◽

10.1590/s1516-31802009000300010 ◽

2009 ◽

Vol 127 (3) ◽

pp. 166-170 ◽

Cited By ~ 6

Author(s):

Marcus Castro Ferreira ◽

Viviane Fernandes de Carvalho ◽

Fábio Kamamoto ◽

Paulo Tuma Junior ◽

André Oliveira Paggiaro

Keyword(s):

Negative Pressure ◽

Case Series ◽

Lower Limbs ◽

Vacuum System ◽

Diabetic Patients ◽

Negative Pressure Therapy ◽

Pressure Therapy ◽

Duration Of Hospitalization ◽

Wound Bed Preparation ◽

To Receive

CONTEXT: Complications from diabetes mellitus affecting the lower limbs occur in 40 to 70% of such patients. Neuropathy is the main cause of ulceration and may be associated with vascular impairment. The wound evolves with necrosis and infection, and if not properly treated, amputation may be the end result. Surgical treatment is preferred in complex wounds without spontaneous healing. After debridement of the necrotic tissue, the wound bed needs to be prepared to receive a transplant of either a graft or a flap. Dressings can be used to prepare the wound bed, but this usually leads to longer duration of hospitalization. Negative pressure using a vacuum system has been proposed for speeding up the treatment. This paper had the objective of analyzing the effects of this therapy on wound bed preparation among diabetic patients. CASE SERIES: Eighty-four diabetic patients with wounds in their lower limbs were studied. A commercially available vacuum system was used for all patients after adequate debridement of necrotic tissues. For 65 patients, skin grafts completed the treatment and for the other 19, skin flaps were used. Wound bed preparation was achieved over an average time of 7.51 days for 65 patients and 10 days for 12 patients, and in only one case was not achieved. CONCLUSIONS: This experience suggests that negative pressure therapy may have an important role in wound bed preparation and as part of the treatment for wounds in the lower limbs of diabetic patients.

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Intrathoracic negative pressure therapy and/or endobronchial valve for pleural empyema minimal invasive management: case series of thirteen patients and review of the literature

Videosurgery and Other Miniinvasive Techniques ◽

10.5114/wiitm.2020.93210 ◽

2020 ◽

Vol 15 (4) ◽

pp. 588-595

Author(s):

Siarhei Panko ◽

Denis Vakulich ◽

Aliaksandr Karpitski ◽

Henadzi Zhurbenka ◽

Andrej Shestiuk ◽

...

Keyword(s):

Negative Pressure ◽

Case Series ◽

Pleural Empyema ◽

Minimal Invasive ◽

Review Of The Literature ◽

Negative Pressure Therapy ◽

Pressure Therapy ◽

Intrathoracic Negative Pressure ◽

Endobronchial Valve ◽

Invasive Management

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Closed-Incision Negative Pressure Therapy in Place of Surgical Drain Placement in Plantar Fibroma Excision Surgery: A Case Series

Cureus ◽

10.7759/cureus.9110 ◽

2020 ◽

Author(s):

Abbey Karlock ◽

Ralph J Napolitano

Keyword(s):

Negative Pressure ◽

Case Series ◽

Negative Pressure Therapy ◽

Pressure Therapy ◽

Drain Placement ◽

Surgical Drain

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Role of Rendezvous-Procedure in the Treatment of Complications after Laparoscopic Sleeve Gastrectomy

Journal of Clinical Medicine ◽

10.3390/jcm10235670 ◽

2021 ◽

Vol 10 (23) ◽

pp. 5670

Author(s):

Dörte Wichmann ◽

Veit Scheble ◽

Stefano Fusco ◽

Ulrich Schweizer ◽

Felix Hönes ◽

...

Keyword(s):

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Negative Pressure ◽

Staple Line ◽

Complication Rates ◽

Negative Pressure Therapy ◽

Pressure Therapy ◽

Staple Line Leaks ◽

Group A ◽

Group B

Introduction: Laparoscopic sleeve gastrectomy is one of the most commonly performed bariatric procedures worldwide with good results, high patient acceptance, and low complication rates. The most relevant perioperative complication is the staple line leak. For the treatment of this complication, endoscopic negative pressure therapy has proven particularly effective. The correct time to start endoscopic negative pressure therapy has not been the subject of studies to date. Methods: Twelve patients were included in this retrospective data analysis over three years. Endoscopic negative pressure therapy was carried out using innovative open pore suction devices. Patients were treated with simultaneous surgery and endoscopy, so called rendezvous-procedure (Group A) or solely endoscopically, or in sequence surgically and endoscopically (Group B). Therapy data of the procedures and outcome measures, including duration of therapy, therapy success, and change of treatment strategy, were collected and analysed. Results: In each group, six patients were treated (mean age 52.96 years, 4 males, 8 females). Poor initial clinical situation, time span of endoscopic negative pressure therapy (Group A 31 days vs. Group B 18 days), and mean length of hospital stay (Group A 39.5 days vs. Group B 20.17 days) were higher in patients with rendezvous procedures. One patient in Group B died during the observation time. Discussion: Rendezvous procedures for patients with staple line leaks after sleeve gastrectomy is indicated for serious ill patients with perigastric abscesses and in need of laparoscopic lavage. The one-stage complication management with the rendezvous procedure seems not to result in an obvious advantage in the further outcome in patients with staple line leaks after laparoscopic sleeve gastrectomy.

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