Comparative evaluation of the effectiveness of vacuum-assisted and traditional laparostomy in diffuse peritonitis

• Sazhin A.V.
• Ivakhov G.B.
• Titkova S.M.
• Andrey V. Teplykh

Abstract

The ongoing problem of high rate of postoperative mortality for diffuse peritonitis with sepsis and septic shock indicate not only the complexity of the problem and the difficulty of its radical solution for many years, despite the modern achievements of intensive care and surgery, but also the need for further search for various methods and tactical approaches in the treatment of this category of patients.

A comparative evaluation of the effectiveness of vacuum-assisted laparostomy and traditional laparostomy in patients with diffuse peritonitis showed the advantage of vacuum-assisted laparostomy as a priority method of temporary closure of the abdominal cavity during the “on program” tactics, which, moreover, allows more often to perform delayed aponeurosis closure at the time of completion of the staged surgical treatment of peritonitis.

Keywords:peritonitis; laparostomy; VAC-laparostomy

References

1.     Savel’ev V.S., Petukhov V.A. Peritonitis and endotoxin aggression. Moscow: Meditsina, 2012: 326 p. (in Russian)

2.     Larichev A.B., Pokrovsky E.Zh., Dzhuguryan A.S., Dylenok A.A. Concerning determination of indications for staging abdominal cavity sanitation at the extentive purelent peritonitis. Vestnik experimental’noy i klinicheskoy khirurgii [Bulletin of Experimental and Clinical Surgery]. 2013; 6 (3): 334–41. (in Russian)

3.     Savel’ev V.S., Gel’fand B.R., Filimonov M.I. (eds). Peritonitis: a practical guide. Moscow: Litterra, 2006: 208 p. (in Russian)

4.     De Waele J.J., Kaplan M., Sugrue M. How to deal with an open abdomen? Anaesthesiol Intensive Ther. 2015; 47 (4): 372–8. DOI: https://doi.org/10.5603/AIT.a2015.0023  

5.     Coccolini F., Montori G., Ceresoli M. IROA: International Register of Open Abdomen, preliminary results. World J Emerg Surg. 2017; 12 (1): 1–10. DOI: https://doi.org/10.1186/s13017-017-0123-8

6.     Rausei S., Dionigi G., Boni L. Open abdomen management of intra-abdominal infections: analysis of a twenty-year experience. Surg Infect. 2014; 15 (3): 200–6. DOI: https://doi.org/10.1089/sur.2012.180

7.     Quyn A.J., Johnston C., Hall D. The open abdomen and temporary abdominal closure systems – historical evolution and systematic review. Colorectal Dis. 2012; 14 (8.): e429–38. DOI: https://doi.org/10.1111/j.1463-1318.2012.03045.x

8.     Atema J.J., Gans S.L., Boermeester M.A. Systematic review and meta-analysis of the open abdomen and temporary abdominal closure techniques in non-trauma patients. World J Surg. 2015; 39: 912–25. DOI: https://doi.org/10.1007/s00268-014-2883-6

9.     Cheatham M.L., Demetriades D., Fabian T.C. Prospective study examining clinical outcomes associated with a negative pressure wound therapy system and Barker’s vacuum packing technique. World J Surg. 2013; 37: 2018–30. DOI: https://doi.org/10.1007/s00268-013-2080-z

10. Lindstedt S., Malmsjö M., Hlebowicz J., Ingemansson R. Comparative study of the microvascular blood flow in the intestinal wall, wound contraction and fluid evacuation during negative pressure wound therapy in laparostomy using the VAC abdominal dressing and the abthera open abdomen negative pressure therapy system. Int Wound J. 2015; 12 (1): 83–8. DOI: https://doi.org/10.1111/iwj.12056

11. Berrevoet F., Lampaert S., Singh K. Early initiation of a standardized open abdomen treatment with vacuum assisted mesh-mediated fascial traction achieves best results. Front Surg. 2021; 7: 606539. DOI: https://doi.org/10.3389/fsurg.2020.606539

12. Cirocchi R., Birindelli A., Biffl W.L. What is the effectiveness of the negative pressure wound therapy (NPWT) in patients treated with open abdomen technique? A systematic review and meta-analysis. J Trauma Acute Care Surg. 2016; 81 (3): 575–84. DOI: https://doi.org/10.1097/TA.0000000000001126

13. Stevens P. Vacuum-assisted closure of laparostomy wounds: a critical review of the literature. Int Wound J. 2009; 6 (4): 259–66. DOI: https://doi.org/10.1111/j.1742-481X.2009.00614.x

14. Chen Y., Ye J., Song W. Comparison of outcomes between early fascial closure and delayed abdominal closure in patients with open abdomen: a systematic review and meta-analysis. Gastroenterol Res Pract. 2014; 2014: 784056. DOI: https://doi.org/10.1155/2014/784056

15. Willms A., Güsgen C., Schaa S. Management of the open abdomen using vacuum-assisted wound closure and mesh-mediated fascial traction. Langenbecks Arch Surg. 2015; 400: 91–9. DOI: https://doi.org/10.1007/s00423-014-1240-4

16. Tolonen M., Mentula P., Sallinen V. Open abdomen with vacuum-assisted wound closure and mesh-mediated fascial traction in patients with complicated diffuse secondary peritonitis: a single-center 8-year experience. J Trauma Acute Care Surg. 2017; 82 (6): 1100–5. DOI: https://doi.org/10.1097/TA.0000000000001452

17. Petersson P., Petersson U. Dynamic fascial closure with vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) treatment of the open abdomen – an updated systematic review. Front Surg. 2020; 7: 577104. DOI: https://doi.org/10.3389/fsurg.2020.577104

18. Diaconescu B., Uranues S., Fingerhut A. The Bucharest ESTES consensus statement on peritonitis. Eur J Trauma Emerg Surg. 2020; 46: 1005–23. DOI: https://doi.org/10.1007/s00068-020-01338-9

19. Leppäniemi A.K. Laparostomy: why and when? Crit Care. 2010; 14: 1–5. DOI: https://doi.org/10.1186/cc8857

20. Kirkpatrick A.W., Roberts D.J., Faris P.D. Active negative pressure peritoneal therapy after abbreviated laparotomy: the intraperitoneal vacuum randomized controlled trial. Ann Surg. 2015; 262 (1): 38–46. DOI: https://doi.org/10.1097/SLA.0000000000001095

21. Roberts D.J., Jenne C.N., Ball C.G. Efficacy and safety of active negative pressure peritoneal therapy for reducing the systemic inflammatory response after damage control laparotomy (the Intra-peritoneal Vacuum Trial): study protocol for a randomized controlled trial. Trials. 2013; 14 (1): 1–14. DOI: https://doi.org/10.1186/1745-6215-14-141

22. Berrevoet F., Lampaert S., Singh K. Early initiation of a standardized open abdomen treatment with vacuum assisted mesh-mediated fascial traction achieves best results. Front Surg. 2021; 7: 1–8. DOI: https://doi.org/10.3389/fsurg.2020.606539

23. Wacha H., Linder M.M. Der Mannheimer Peritonitis-Index – ein Instrument zur intraoperativen Prognose der Peritonitis. In: Peritonitis: Grundsätzliches zur Therapie. Berlin; Heidelberg: Springer, 1987: 73–100. DOI: https://doi.org/10.1007/978-3-642-73008-5_6

24. Sartelli M., Abu-Zidan F.M., Catena F. Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections: a prospective multicentre study (WISS Study). World J Emerg Surg. 2015; 10 (1): 61. DOI: https://doi.org/10.1186/s13017-015-0055-0

25. Sartelli M., Abu-Zidan F.M., Labricciosa F.M. Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) Study: a WSES observational study. World J Emerg Surg. 2019; 14 (1): 1–11. DOI: https://doi.org/10.1186/s13017-019-0253-2

26. Clavien P.A., Barkun J., De Oliveira M.L. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009; 250 (2): 187–96. DOI: https://doi.org/10.1097/SLA.0b013e3181b13ca2

27. Rasilainen S., Mentula P., Salminen P. Superior primary fascial closure rate and lower mortality after open abdomen using negative pressure wound therapy with continuous fascial traction. J Trauma Acute Care Surg. 2020; 89 (6): 1136–42. DOI: https://doi.org/10.1097/TA.0000000000002889

28. Coccolini F., Catena F., Montori G. IROA: The International Register of Open Abdomen: an international effort to better understand the open abdomen: call for participants. World J Emerg Surg. 2015; 10 (1): 4–6. DOI: https://doi.org/10.1186/s13017-015-0029-2

29. Cicuttin E., Ansaloni L., Ceresoli M. Trends in open abdomen management in Italy: a subgroup analysis from the IROA project. Updates Surg. 2020; 72 (1): 171–7. DOI: https://doi.org/10.1007/s13304-019-00687-4

30. Bleszynski M.S., Chan T., Buczkowski A.K. Open abdomen with negative pressure device vs primary abdominal closure for the management of surgical abdominal sepsis: a retrospective review. Am J Surg. 2016; 211 (5): 926–32. DOI: https://doi.org/10.1016/j.amjsurg.2016.01.012

31. Carlson G.L., Patrick H., Amin A.I. Management of the open abdomen: a national study of clinical outcome and safety of negative pressure wound therapy. Ann Surg. 2013; 257 (6): 1154–9.

32. Cheng Y., Wang K., Gong J. Negative pressure wound therapy for managing the open abdomen in non-trauma patients. Cochrane Database Syst Rev. 2022; 5: CD013710. DOI: https://doi.org/10.1002/14651858.CD013710.pub2

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