Comparison of the Effectiveness of the Treatment Using Standard Methods and Negative Pressure Wound Therapy (NPWT) in Patients Treated with Open Abdomen Technique

• Authors: Krzysztof Szmyt , Łukasz Krokowicz , Adam Bobkiewicz , Bartosz Cybułka , Witold Ledwosiński , Maciej Gordon , Ahmed Alammari , Tomasz Banasiewicz , Michał Drews
• Languages of publication: EN

Abstracts

EN

Open abdomen technique is a surgical treatment in which the fascia and skin are left open in order to reduce the value of the intra-abdominal pressure. According to the World Society of the Abdominal Compartment Syndrome (WSACS) normal values of the intra-abdominal pressure are between 5 and 7 mm Hg. Intra-abdominal hypertension occurs when the pressure value is equal to or exceeds 12 mm Hg.The aim of the study was to compare the results of the open abdomen treatment using standard methods and negative pressure wound therapy.Material and methods. The study was in the form of a retrospective analysis of the documentation of the patients treated with open abdomen technique. The study included 37 patients treated in the Department of General and Endocrine Surgery and Gastroenterological Oncology and in the Department of Anesthesiology and Intensive Care of the Medical Sciences since 2009-2012. Patients were divided into two groups: group 1 (n = 20) was treated with standard surgical procedures (laparostomy, repeated peritoneal cavity lavage) and group 2 (n =17) was treated using negative pressure wound therapy (NPWT). The analysed clinical data included the period of hospitalization and clinical outcome (survival vs death), the occurrence of enteroatmospheric fistulae, cyclical determination of the quantitative C-reactive protein levels.Results. The number of deaths during hospitalization in the group treated with NPWT was lower than in the group treated with standard methods (3 vs 9). The number of fistulae during hospitalization in the group treated with NPWT dropped as compared to the group treated using standard procedures (18% vs 70%). The decrease in the CRP levels was recorded in the group treated with NPWT and its increase - in the group treated with standard methods. Conclusions. The use of NPWT in patients requiring open abdomen treatment is reasonable due to the positive results with respect to survival rates and the decrease in the number of gastrointestinal fistulae. It is necessary to train the physicians in using this type of therapy in the form of workshops and in the clinical setting.

Keywords

EN

C-reactive protein; negative pressure wound therapy; open abdomen

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2015
• Volume: 87
• Issue: 1
• Pages: 22-30

Dates

online

1 - 3 - 2015

received

17 - 7 - 2014

Contributors

author

Krzysztof Szmyt

• Department of General and Endocrine Surgery and Gastroenterological Oncology, Poznań University of Medical Sciences Kierownik: prof. dr hab. M. Drews

author

Łukasz Krokowicz

• Department of General and Endocrine Surgery and Gastroenterological Oncology, Poznań University of Medical Sciences Kierownik: prof. dr hab. M. Drews

author

Adam Bobkiewicz

• Department of General and Endocrine Surgery and Gastroenterological Oncology, Poznań University of Medical Sciences Kierownik: prof. dr hab. M. Drews

author

Bartosz Cybułka

• Department of Surgery, Independent Public Healthcare Institution, Grodzisk Wielkopolski Ordynator: lek. A. Wach

author

Witold Ledwosiński

• Department of Surgery, Independent Public Healthcare Institution, Grodzisk Wielkopolski Ordynator: lek. A. Wach

author

Maciej Gordon

• Department of Anesthesiology and Intensive Care, Poznań University of Medical Sciences Kierownik: prof. dr hab. L. Drobnik

author

Ahmed Alammari

• Department of Anesthesiology and Intensive Care, Poznań University of Medical Sciences Kierownik: prof. dr hab. L. Drobnik

author

Tomasz Banasiewicz

• Department of General and Endocrine Surgery and Gastroenterological Oncology, Poznań University of Medical Sciences Kierownik: prof. dr hab. M. Drews

author

Michał Drews

• Department of Surgery, Independent Public Healthcare Institution, Grodzisk Wielkopolski Ordynator: lek. A. Wach

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Identifiers

DOI

10.1515/pjs-2015-0013