Uso de terapia con presión negativa en heridas con fístulas entéricas

Ruiz-López, Manuel; Campos, Joaquín; Pérez, Belinda Sánchez; Sánchez, Antonio González; Aguilar, José Luis Fernández; Navarro, José Antonio Bondía

doi:10.1016/j.ciresp.2009.01.029

Cited by 9 publications

(8 citation statements)

References 7 publications

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“…On the other hand, certain medical papers discuss the positive results of VAC therapy in treatment of intestinal fistulas [10], though the efficacy of VAC therapy is associated mostly with the control of fluid excretion and the improvement of the local conditions of the wounds [21], rather than a complete healing of fistulas, which is very rare [22]. …”

Section: Discussionmentioning

confidence: 99%

Vacuum-assisted closure therapy in patients with large postoperative wounds complicated by multiple fistulas.

Banasiewicz

Borejsza-Wysocki²,

Meissner³

et al. 2011

Videosurgery and Other Miniinvasive Techniques

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Vacuum-assisted closure (VAC) therapy is a widely acknowledged method for chronic and traumatic wound healing. The feasibility of VAC therapy used for the treatment of intestinal fistulas is still a subject of debate. Complex postoperative wounds pose significant therapeutic problems, especially when there are several fistula openings in the wound area and other sites, usually at the site of previous drains. This paper describes the treatment of three patients in a critical condition, with complex postoperative wounds complicated by multiple fistulas. Vacuum-assisted closure therapy was based on effective drainage of the biggest fistula opening and ensuring conditions promoting the healing process of other fistulas and the wound. A considerable improvement in general condition and wound healing was noted within 2-4 weeks and both the number of fistulas and the volume of excreted contents decreased. After 5-7 weeks a significant improvement in wound healing was observed in all patients. Once the general condition of all patients was considered satisfactory (2-6 months), they underwent surgery aimed at restoration of the digestive tract continuity.In our opinion, VAC therapy used for the treatment of postoperative wounds with multiple fistulas in the wound area and other sites should aim mainly at the improvement of patients’ general condition, limitation of the number of fistulas as well as accelerated wound healing. This may lead to formation of one stoma-type fistula, which can be dressed and cared for by patients until the continuity of the digestive tract has been surgically restored.

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Section: Discussionmentioning

confidence: 99%

Vacuum-assisted closure therapy in patients with large postoperative wounds complicated by multiple fistulas.

Banasiewicz

Borejsza-Wysocki²,

Meissner³

et al. 2011

Videosurgery and Other Miniinvasive Techniques

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“…A total of six RCTs investigated multiple abdominal surgeries, among which three showed that pVSD reduced the incidence of SSIs,32, 35, 36 two showed that pVSD did not reduce the incidence of SSIs,33, 37 and one showed that VSD reduced the incidence of SSIs, but the differences were not significant 34 . Eleven observational studies of abdominal surgeries, including pediatric contaminated surgery, gynecological malignancy surgery, cesarean section surgery, and liver transplantation surgery, also showed that pVSD reduced the incidence of incision infections 44, 45, 49, 50, 52, 57, 59, 65. One RCT showed that pVSD reduced postoperative pain and the need for anesthetics 34 ; however, although the incidence of SSIs decreased, the difference was not significant.…”

Section: Recommendationsmentioning

confidence: 99%

“…A total of 35 articles discussed prophylactic VSD (pVSD) for abdominal incisions with primary suture, of which 6 were RCTs 32 , 33 , 34 , 35 , 36 , 37 and 29 were observational studies. 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 …”

Section: Recommendationsmentioning

confidence: 99%

“… 34 Eleven observational studies of abdominal surgeries, including pediatric contaminated surgery, gynecological malignancy surgery, cesarean section surgery, and liver transplantation surgery, also showed that pVSD reduced the incidence of incision infections. 44 , 45 , 49 , 50 , 52 , 57 , 59 , 65 One RCT showed that pVSD reduced postoperative pain and the need for anesthetics 34 ; however, although the incidence of SSIs decreased, the difference was not significant.…”

Section: Recommendationsmentioning

confidence: 99%

“…Ruiz-Lopez et al. 52 found that VSD after abdominal infection and/or abdominal hypertension shortened the recovery time and increased the success rate of abdominal closure. Additionally, Kirkpatrick et al.…”

Section: Recommendationsmentioning

confidence: 99%

See 2 more Smart Citations

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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