Aim
The negative pressure wound therapy (NPWT) is more and more often used in open abdomen treatment.There are few experiments with this approach in Hungary. The aim of this study was to evaluate the efficiency and safety of NPWT in open abdomen therapy.
Methods
The inclusion criterias for this multicentric, prospective observational study (ethical permission: 096531/OTIG) was the prevention or tretament of abdominal compartment syndrome (26.2%), impossible abdominal wall closure due to septic complications or trauma (71.4%) and damage controll surgery (2.4%).
Exclusion criteria was active bleeding, tumour growth in the wound, undiagnosed enteral fistule and the absence of patient’s permission. The causative disease of the 42 patients (mean age: 65.2±14.4 years, male/female rate: 54.8:45.2%, mean BMI: 17.5±7.0) was malignancy in 30.1%, untreatable consecutive paralytic ileus in 26.2%, acute pancreatitis in 16.7% and others in 27%. The visits were performed at the begining, on the 15th day and at the end of the NPWT.
Results
The decrease of intraabdominal pressure during NPWT was significant between the 2-3 and 1-3 visits. The decrease of the wound size (width, lenght, depth) was siginificant in all the three dimensions. The rapidity of wound size decrease was 0.41 cm/day between the 1-2nd visit, 0.128 cm/day between the 2-3rd visit with a mean level of 0.19 cm/day. The efficiency rate of the NPWT was 66.7%. The overal mortality rate was 33.3%. The mean time of the NPWT was 26.4 days.
Conclusion
The NPWT was effective to decrease the pressure in cases of abdominal hypertension and compartment syndrome. During the NPWT in open abdomen therapy the size of wound decreased significantly. The rate of successful treatment was 66.6% with a mean mortality rate of 33.3%.
Clinical relevance
To introduce a new methode for the treatment of open abdomen therapy
