TNP-assisted fascial closure in a patient with acute abdomen and abdominal compartment syndrome

Abstract

Topical negative pressure was applied to prevent abdominal compartment syndrome in a patient following surgery for an acute abdomen. It delayed fascial closure, protected the underlying bowel and facilitated abdominal re-entry.

Growth factors, silver dressings and negative pressure wound therapy in the management of hard-to-heal postoperative wounds in obstetrics and gynecology: a review

“… Stannard et al [ 55 ] Case series 2 patients P1: BMI 50 kg/m 2 after TAH + BSO for endometrial cancer P2: BMI 60 kg/m 2 after TAH + BSO for endometrial cancer Prophylactic NPWT Continuous negative pressure of 125 mmHg for 4 days after surgery 9. Gourgiotis et al [ 56 ] Case report 67 years old patient, BMI 41 kg/m 2 , fascial dehiscence and skin defect after TAH + BSO for endometrial cancer and relaparotomy for sigmoid colon perforation, abdominal compartment syndrome VAC Dressing replacement every 48 h 10. Lavoie et al [ 57 ] Case report 73 year old patient, BMI 50 kg/m 2 , with wound hematoma and adipose tissue necrosis after TAH + BSO for endometrial cancer NPWT with gauze filler NA 11.…”

“… Stannard et al [ 55 ] P1: complete wound closure after 4 weeks P2: uncomplicated wound healing P1: 4 weeks postoperatively P2: 4 days postoperatively P1: superficial skin separation on postoperative day 14 NA 9. Gourgiotis et al [ 56 ] Complete fascial closure after 21 days 3 months None NA 10. Lavoie et al [ 57 ] 7 days of therapy; patient discharge after 36 days following debridement; complete wound closure after 82 days following debridement; no skin grafting required 2 months None NA 11.…”

“…In a case series study by Stannard et al, the authors suggested a possibility of a prophylactic use of NPWT directly after the surgery (continuous negative pressure of 125 mmHg for 4 days) to prevent wound infection and breakdown in morbidly obese patients subjected to abdominal hysterectomy [ 55 ]. In another case report by Gourgiotis et al the application of topical VAC therapy in patient with abdominal compartment syndrome and skin defect following major gynecologic surgery reduced the need for fluids and vasopressor agents, prevented fascial retraction and visceral adherence, and finally enabled delayed fascial closure [ 56 ]. Lavoie et al presented effective use of NPWT with gauze filling in the case of extensive adipose tissue necrosis following abdominal hysterectomy [ 57 ].…”