Intraabdominelle Vakuumtherapie des offenen Abdomens - Eine retrospektive Analyse von 82 konsekutiven Patienten

Abstract

Abdominal vacuum therapy simplifies the treatment of patients with abdominal catastrophes such as peritonitis or necrotising pancreatitis. The cost-effective intraperitoneal use of a foam dressing without a fenestrated polyurethane layer was possible without an increased rate of fistulas. This retrospective analysis demonstrates that abdominal vacuum therapy can be performed without complications in the majority of patients. Furthermore, direct fascial closure is possible in almost half of the patients.

Chinese Trauma Surgeon Association for management guidelines of vacuum sealing drainage application in abdominal surgeries—Update and systematic review

“…A total of 19 articles involving VSD-related secondary intestinal injury after abdominal surgery were included, of which 2 were RCTs 143 , 144 and 17 were retrospective studies. 19 , 30 , 55 , 93 , 98 , 130 , 145 , 146 , 147 , 148 , 149 , 150 , 151 , 152 , 153 , 154 , 155 …”

“…For patients who had no intestinal fistula before surgery, the incidence of intestinal fistula was 1.6%–37% after VSD-assisted TAC. 19 , 93 , 98 , 130 , 144 , 145 , 146 , 147 , 148 , 149 , 150 , 151 In the prospective studies, two RCTs 143 , 144 compared the incidence of intestinal fistulas in TAC surgeries using VSD and absorbable mesh fixed on the abdominal fascia and found no significant differences. Among the five observational studies, Plaudis et al.…”

“…Five observational studies have shown that OA negative pressure wound treatment does not increase the incidence of intestinal fistulas. 98 , 145 , 147 , 151 , 155 Shaikh et al. 155 observed 42 cases of VSD treatment for abdominal incision dehiscence and OA over 5 years.…”

Current Concepts in Negative Pressure Wound Therapy

“…6 Enteric fistulae have been reported in humans undergoing open-abdomen NPWT. 6,81,82 Pain is commonly identified as a complication of NPWT in human patients, and in some patients pain is so severe that it results in discontinuation of the therapy. 6,64,69,83 Pain occurs most frequently when the vacuum unit is turned on and begins to pull a vacuum and typically subsides by 20 to 30 minutes.…”

Chirurgie unter demografisch und gesundheitsökonomisch veränderten Rahmenbedingungen – Chance oder Begrenzung?

“…Daneben ist eine außerordentliche Fortentwicklung in der Humanmedizin nicht zuletzt durch enorme wissenschaftliche und technologische Fortschritte zu verzeichnen, die sich gut durch " die neuen operativen Techniken, insbesondere minimalinvasiv, bzw. interventionellen Herangehensweisen [4][5][6][7], " verbesserte bildgebende Diagnostik mit optimierten entitätsklärenden, präoperativen oder verlaufsbeurteilenden Aussagen, als auch " die Weiterentwicklungen in der Intensivmedizin und Anästhesie [8], " die Medikamentenentwicklung ("Targeted therapy", "Biologicals" etc.) [9,10] umreißen lassen.…”