“…The review of 18 series with overall 1395 patients managed by OA and V.A.C. revealed a mean rate of EAFs 6.1% (Table 2), (4,8,14,17,19,20,(26)(27)(28)(29)31,32,(36)(37)(38)42,45,47), which is comparable to 7.2% in our series.…”
INTRODUCTION:In the past two decades, the open abdomen (OA) technique has gained wide popularity as an effective approach in the cases with severe peritonitis, abdominal compartment syndrome and critical trauma. However, it is still associated with high complication rate. Enteroatmospheric fistulas are the most devastating complication. Despite the numerous techniques described in the literature, their management remains a challenging task.
“…The review of 18 series with overall 1395 patients managed by OA and V.A.C. revealed a mean rate of EAFs 6.1% (Table 2), (4,8,14,17,19,20,(26)(27)(28)(29)31,32,(36)(37)(38)42,45,47), which is comparable to 7.2% in our series.…”
INTRODUCTION:In the past two decades, the open abdomen (OA) technique has gained wide popularity as an effective approach in the cases with severe peritonitis, abdominal compartment syndrome and critical trauma. However, it is still associated with high complication rate. Enteroatmospheric fistulas are the most devastating complication. Despite the numerous techniques described in the literature, their management remains a challenging task.
“…Use of TNP therapy in these situations may lower the reconstructive requirements of the wound. 26 The TNP therapy dressings also require less nursing staff input than traditional dressings as the dressings are changed less often.…”
In clinical practice many wounds are slow to heal and difficult to manage. The recently introduced technique of topical negative pressure therapy (TNP) has been developed to try to overcome some of these difficulties. TNP applies a controlled negative pressure to the surface of a wound that has potential advantages for wound treatment and management. Although the concept itself, of using suction in wound management is not new, the technique of applying a negative pressure at the surface of the wound is. This paper explores the origins and proposed mechanisms of action of TNP therapy and discusses the types of wounds that are thought to benefit most from use of this system.
“…Despite the poor methodology inherent in the open abdomen literature (i.e., mixed patient cohorts, lack of complete inclusion, ignorance of nonsurvivors, variable individual surgeon effort and interest), it is evident that the application of negative suction dressings at subsequent operations has improved closure rates and reduced complications, such as intestinal fistulae. Whether "homegrown" 62 or commercially derived, 63 these technologies have become commonplace. The 2 dominant principles when using negative suction therapy remain: maintenance of the peritoneal/ abdominal domain and continuous and progressive tension on the midline abdominal wall.…”
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