Abdominal Compartment Syndrome (ACS) has multiple causes, and decompressive laparotomy has been the most frequent modality to prevent worsening cardiovascular, respiratory, and renal function. This pilot study evaluated the utility of percutaneous drainage (PD) of peritoneal fluid compared with decompressive laparotomy in burn patients. A 26-month review was conducted. Nine of 13 (69%) study patients developed intra-abdominal hypertension (IAH) that progressed to abdominal compartment syndrome in 4 (31%). All were treated with PD using a diagnostic peritoneal lavage catheter. Peritoneal fluid analysis revealed a sterile plasma ultrafiltrate with electrolyte and other chemistries reflecting patient serum levels. Five patients underwent PD successfully, and their IAH did not progress to ACS. Four patients with greater than 80% TBSA and severe inhalation injury did not respond to PD and required decompressive laparotomy. There was no evidence of bowel edema, ischemia, or necrosis. All patients requiring decompressive laparotomies died either from sepsis or respiratory failure. Percutaneous decompression is a safe and effective method of decreasing IAH and preventing ACS in patients with less than 80% TBSA thermal injury.

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Kennametal’s UltraFlex surface treatments provide wear and corrosion resistant coatings in locations that are not easily protected by other methods such as weld overlay or thermal spray. The UltraFlex surface treatments are based on a powder metallurgy process where coatings are applied to substrates in a “green” state and then heated to fuse the coating into a dense, uniform, metallurgically bonded layer with almost no porosity. Unlike most weld or spraying processes, the process for applying UltraFlex does not require direct line-of-sight with the substrate, so components with very complex geometries, difficult to reach locations, or small IDs can be protected with a high-quality surface. UltraFlex coatings are available in multiple grades which are selected depending on the specific application environment. UltraFlex tungsten carbide grades have excellent abrasion and erosion resistance and cobalt alloy grades have excellent corrosion and high temperature resistance.