Outcome of Negative‐Pressure Wound Therapy for Open Abdomen Treatment After Nontraumatic Lower Gastrointestinal Surgery: Analysis of Factors Affecting Delayed Fascial Closure in 101 Patients

Bertelsen, Claus Anders; Fabricius, Rasmus; Kleif, Jakob; Kristensen, Bent Bruun; Gögenur, Ismail

doi:10.1007/s00268-013-2360-7

Cited by 25 publications

(12 citation statements)

References 46 publications

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“…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 …”

Section: Recommendationsmentioning

confidence: 99%

“…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.…”

Section: Recommendationsmentioning

confidence: 99%

“…A total of 14 articles were included, of which 12 were observational studies48, 61, 62, 63, 66, 112, 129, 130, 131, 132, 133 and 2 were animal experimental studies 87, 88…”

Section: Recommendationsmentioning

confidence: 99%

“…After then negative pressure drainage was applied to promote granulation. One observational study concluded that direct contact of the dressing with the intestinal tract had the risk of causing an intestinal fistula 130 . With respect to negative pressure in abdominal wall defects, six observational studies recommend that the negative pressure should be at the range of 70–100 mm Hg 61, 62, 63, 66, 112, 132…”

Section: Recommendationsmentioning

confidence: 99%

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

Sun

et al. 2019

Chinese Journal of Traumatology

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Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chinese Trauma Surgeon Association organized a committee composed of 28 experts across China in July 2017, aiming to provide an evidence-based recommendation for the application of VSD in abdominal surgeries. Eleven questions regarding the use of VSD in abdominal surgeries were addressed: (1) which type of materials should be respectively chosen for the intraperitoneal cavity, retroperitoneal cavity and superficial incisions? (2) Can VSD be preventively used for a high-risk abdominal incision with primary suture? (3) Can VSD be used in severely contaminated/infected abdominal surgical sites? (4) Can VSD be used for temporary abdominal cavity closure under some special conditions such as severe abdominal trauma, infection, liver transplantation and intra-abdominal volume increment in abdominal compartment syndrome? (5) Can VSD be used in abdominal organ inflammation, injury, or postoperative drainage? (6) Can VSD be used in the treatment of intestinal fistula and pancreatic fistula? (7) Can VSD be used in the treatment of intra-abdominal and extra-peritoneal abscess? (8) Can VSD be used in the treatment of abdominal wall wounds, wound cavity, and defects? (9) Does VSD increase the risk of bleeding? (10) Does VSD increase the risk of intestinal wall injury? (11) Does VSD increase the risk of peritoneal adhesion? Focusing on these questions, evidence-based recommendations were given accordingly. VSD was strongly recommended regarding the questions 2–4. Weak recommendations were made regarding questions 1 and 5–11. Proper use of VSD in abdominal surgeries can lower the risk of infection in abdominal incisions with primary suture, treat severely contaminated/infected surgical sites and facilitate temporary abdominal cavity closure.

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Section: Recommendationsmentioning

confidence: 99%

Section: Recommendationsmentioning

confidence: 99%

“…A total of 14 articles were included, of which 12 were observational studies48, 61, 62, 63, 66, 112, 129, 130, 131, 132, 133 and 2 were animal experimental studies 87, 88…”

Section: Recommendationsmentioning

confidence: 99%

Section: Recommendationsmentioning

confidence: 99%

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

Sun

et al. 2019

Chinese Journal of Traumatology

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“…Management of the open abdomen in acute care surgery is, for the most part, even more challenging than in the context of trauma. Particularly when the primary indication for the open abdomen occurs in the setting of peritonitis and intra-abdominal sepsis [62][63][64][65]. Closure of the abdominal wall with synthetic mesh under these conditions is associated with high incidence of infection and fistula formation [66-Citation: Rezende-Neto J, Rotstein O (2017) "Genuine" Damage Control Laparotomy in Peritonitis: A Twenty-Year Review.…”

Section: Management Of the Open Abdomen In The Setting Of Peritonitismentioning

confidence: 99%

“Genuine” Damage Control Laparotomy in Peritonitis: A Twenty-Year Review

Rezende-Neto¹,

Rotstein²

2017

J Surg

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Negative Pressure Wound Therapy for Closed Laparotomy Incisions in General and Colorectal Surgery

et al. 2018

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IMPORTANCE Surgical site infections (SSIs) are common after laparotomy wounds and are associated with a significant economic burden. The use of negative pressure wound therapy (NPWT) has recently been broadened to closed surgical incisions. OBJECTIVE To evaluate the association of prophylactic NPWT with SSI rates in closed laparotomy incisions performed for general and colorectal surgery in elective and emergency settings. DATA SOURCES The PubMed, Embase, Cochrane Central Register of Controlled Trials, and Google Scholar databases were searched without language restrictions for relevant articles from inception until December 2017. The latest search was performed on December 31, 2017. The bibliographies of retrieved studies were further screened for potential additional studies. STUDY SELECTION Randomized clinical trials and nonrandomized studies were included. Unpublished reports were excluded, as were studies that examined NPWT (or standard nonpressure) dressings only without a comparator group. Studies that evaluated the use of NPWT in open abdominal incisions were also excluded. Disagreement was resolved by discussion, and if the question remained unsettled, the opinion of the senior author was sought. A total of 198 citations were identified, and 189 were excluded. DATA EXTRACTION AND SYNTHESIS This meta-analysis was conducted according to PRISMA guidelines. Data were independently extracted by 2 authors. A random-effects model was used for statistical analysis. MAIN OUTCOMES AND MEASURES The primary outcome measure was SSI, and secondary outcomes included seroma and wound dehiscence rates. These outcomes were chosen before data collection. RESULTS Nine unique studies (3 randomized trials and 2 prospective and 4 retrospective studies) capturing 1266 unique patients were included. Of these, 1187 patients with 1189 incisions were included in the final analysis (52.3% male among 7 studies reporting data on sex; mean [SD] age, 52 [15] years among 8 studies reporting data on age). Significant clinical and methodologic heterogeneity existed among studies. On random-effects analysis, NPWT was associated with a significantly lower rate of SSI compared with standard dressings (pooled odds ratio [OR], 0.25; 95% CI, 0.12-0.52; P < .001). However, no difference in rates of seroma (pooled OR, 0.38; 95% CI, 0.12-1.23; P = .11) or wound dehiscence (pooled OR, 2.03; 95% CI, 0.61-6.78; P = .25) was found. On sensitivity analysis, focusing solely on colorectal procedures, NPWT significantly reduced SSI rates (pooled OR, 0.16; 95% CI, 0.07-0.36; P < .001). CONCLUSIONS AND RELEVANCE Application of NPWT on closed laparotomy wounds in general and colorectal surgery is associated with reduced SSI rates but similar rates of seroma and wound dehiscence compared with conventional nonpressure dressings.

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Outcome of Negative‐Pressure Wound Therapy for Open Abdomen Treatment After Nontraumatic Lower Gastrointestinal Surgery: Analysis of Factors Affecting Delayed Fascial Closure in 101 Patients

Abstract: OA using NPWT seems to be a safe procedure, with few procedure-related complications. Failure of fascial closure is related to the indication of OA and the presence of a stoma. Prospective multicenter studies are needed to establish which patients with lower GI surgery benefit from OA.

Cited by 25 publications

References 46 publications

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

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

“Genuine” Damage Control Laparotomy in Peritonitis: A Twenty-Year Review

Negative Pressure Wound Therapy for Closed Laparotomy Incisions in General and Colorectal Surgery

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