Negative Pressure Therapy in Abdominal Compartment Syndrome

2017 ◽  
Vol 68 (8) ◽  
pp. 1923-1926
Author(s):  
Bogdan Mihnea Ciuntu ◽  
Ciprian Vasiluta ◽  
Nicoleta Anton ◽  
Roxana Ciuntu ◽  
Mihaela Damian ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Negative Pressure ◽  
Open Abdomen ◽  
Negative Pressure Therapy ◽  
Vacuum Assisted Closure ◽  
Pressure Therapy ◽  
Abdominal Hypertension ◽  
Severity Scores ◽  
Abdominal Compartment

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.

scholarly journals Serial abdominal closure with Gore-tex mesh and Rives-Stoppa for an open abdomen secondary to intra-abdominal hypertension in burns

2018 ◽  
Vol 51 (03) ◽  
pp. 324-326 ◽  
Author(s):  
R Raja Shanmugakrishnan ◽  
Charles Yuen Yung Loh ◽  
Abhijeet Wakure ◽  
Naguib El-Muttardi
Keyword(s):  
Compartment Syndrome ◽  
Abdominal Wall ◽  
Abdominal Compartment Syndrome ◽  
Open Abdomen ◽  
Excess Pressure ◽  
Separation Technique ◽  
Abdominal Wall Closure ◽  
Decompressive Laparotomy ◽  
Abdominal Hypertension ◽  
Abdominal Compartment

ABSTRACTIntra-abdominal hypertension (IAH) leading to abdominal compartment syndrome (ACS) commonly occurs in major burns. To relieve the excess pressure, decompressive laparotomy is done which can lead to an open abdomen. Closure of the abdomen after a decompressive laparotomy is very difficult with bowel oedema. We describe our technique of closing the open abdomen in such situations with a combination of serial abdominal wall closure with a layered mesh and the Rives-Stoppa component separation technique.

scholarly journals Intra-abdominal hypertension and abdominal compartment syndrome in critically ill patients: A narrative review of past, present, and future steps

2021 ◽  
pp. 145749692110301
Author(s):  
Marije Smit ◽  
Matijs van Meurs ◽  
Jan G. Zijlstra
Keyword(s):  
Compartment Syndrome ◽  
Critically Ill ◽  
Abdominal Compartment Syndrome ◽  
Critically Ill Patients ◽  
Open Abdomen ◽  
Surgical Decompression ◽  
Abdominal Pressure ◽  
Pressure Monitoring ◽  
Abdominal Hypertension ◽  
Abdominal Compartment

Background and objective: Intra-abdominal hypertension is frequently present in critically ill patients and is an independent predictor for mortality. In this narrative review, we aim to provide a comprehensive overview of current insights into intra-abdominal pressure monitoring, intra-abdominal hypertension, and abdominal compartment syndrome. The focus of this review is on the pathophysiology, risk factors and outcome of intra-abdominal hypertension and abdominal compartment syndrome, and on therapeutic strategies, such as non-operative management, surgical decompression, and management of the open abdomen. Finally, future steps are discussed, including propositions of what a future guideline should focus on. Conclusions: Pathological intra-abdominal pressure is a continuum ranging from mild intra-abdominal pressure elevation without clinically significant adverse effects to substantial increase in intra-abdominal pressure with serious consequences to all organ systems. Intra-abdominal pressure monitoring should be performed in all patients at risk of intra-abdominal hypertension. Although continuous intra-abdominal pressure monitoring is feasible, this is currently not standard practice. There are a number of effective non-operative medical interventions that may be performed early in the patient’s course to reduce intra-abdominal pressure and decrease the need for surgical decompression. Abdominal decompression can be life-saving when abdominal compartment syndrome is refractory to non-operative treatment and should be performed expeditiously. The objectives of open abdomen management are to prevent fistula and to achieve delayed fascial closure at the earliest possible time. There is still a lot to learn and change. The 2013 World Society of Abdominal Compartment Syndrome guidelines should be updated and multicentre studies should evaluate the effect of intra-abdominal hypertension treatment on patient outcome.

scholarly journals Treatment of the open abdomen with topical negative pressure therapy: a retrospective study of 46 cases

2011 ◽  
Vol 8 (3) ◽  
pp. 274-279 ◽  
Author(s):  
Aleidis Caro ◽  
Carles Olona ◽  
Andrea Jiménez ◽  
Jordi Vadillo ◽  
Francesc Feliu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Negative Pressure ◽  
Open Abdomen ◽  
Negative Pressure Therapy ◽  
Pressure Therapy ◽  
Topical Negative Pressure
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