Cargando…
Microvascular blood flow response in the intestinal wall and the omentum during negative wound pressure therapy of the open abdomen
PURPOSE: Higher closure rates of the open abdomen have been reported with negative pressure wound therapy (NPWT) compared with other wound therapy techniques. However, the method has occasionally been associated with increased development of intestinal fistulae. The present study measures microvascu...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer-Verlag
2011
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3281201/ https://www.ncbi.nlm.nih.gov/pubmed/21938450 http://dx.doi.org/10.1007/s00384-011-1317-2 |
_version_ | 1782223934126555136 |
---|---|
author | Hlebowicz, Joanna Hansson, Johan Lindstedt, Sandra |
author_facet | Hlebowicz, Joanna Hansson, Johan Lindstedt, Sandra |
author_sort | Hlebowicz, Joanna |
collection | PubMed |
description | PURPOSE: Higher closure rates of the open abdomen have been reported with negative pressure wound therapy (NPWT) compared with other wound therapy techniques. However, the method has occasionally been associated with increased development of intestinal fistulae. The present study measures microvascular blood flow in the intestinal wall and the omentum before and during NPWT. METHODS: Six pigs underwent midline incision and application of NPWT to the open abdomen. The microvascular blood flow in the underlying intestinal loop wall and the omentum was recorded before and after the application of NPWT of −50, −70, −100, −120, −150, and −170 mmHg respectively, using laser Doppler velocimetry. RESULTS: A significant decrease in microvascular blood flow was seen in the intestinal wall during application of all negative pressures levels. The blood flow was 2.7 (±0.2) Perfusion Units (PU) before and 2.0 (±0.2) PU (*p < 0.05) after application of −50 mmHg, and 3.6 (±0.6) PU before and 1.5 (±0.2) PU (**p < 0.01) after application of −170 mmHg. CONCLUSIONS: In the present study, we show that negative pressures between −50 and −170 mmHg induce a significant decrease in the microvascular blood flow in the intestinal wall. The decrease in blood flow increased with the amount of negative pressure applied. One can only speculate that a longstanding decreased blood flow in the intestinal wall may induce ischemia and secondary necrosis in the intestinal wall, which, theoretically, could promote the development of intestinal fistulae. We believe that NPWT of the open abdomen is a very effective treatment but could probably be improved. |
format | Online Article Text |
id | pubmed-3281201 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | Springer-Verlag |
record_format | MEDLINE/PubMed |
spelling | pubmed-32812012012-03-01 Microvascular blood flow response in the intestinal wall and the omentum during negative wound pressure therapy of the open abdomen Hlebowicz, Joanna Hansson, Johan Lindstedt, Sandra Int J Colorectal Dis Original Article PURPOSE: Higher closure rates of the open abdomen have been reported with negative pressure wound therapy (NPWT) compared with other wound therapy techniques. However, the method has occasionally been associated with increased development of intestinal fistulae. The present study measures microvascular blood flow in the intestinal wall and the omentum before and during NPWT. METHODS: Six pigs underwent midline incision and application of NPWT to the open abdomen. The microvascular blood flow in the underlying intestinal loop wall and the omentum was recorded before and after the application of NPWT of −50, −70, −100, −120, −150, and −170 mmHg respectively, using laser Doppler velocimetry. RESULTS: A significant decrease in microvascular blood flow was seen in the intestinal wall during application of all negative pressures levels. The blood flow was 2.7 (±0.2) Perfusion Units (PU) before and 2.0 (±0.2) PU (*p < 0.05) after application of −50 mmHg, and 3.6 (±0.6) PU before and 1.5 (±0.2) PU (**p < 0.01) after application of −170 mmHg. CONCLUSIONS: In the present study, we show that negative pressures between −50 and −170 mmHg induce a significant decrease in the microvascular blood flow in the intestinal wall. The decrease in blood flow increased with the amount of negative pressure applied. One can only speculate that a longstanding decreased blood flow in the intestinal wall may induce ischemia and secondary necrosis in the intestinal wall, which, theoretically, could promote the development of intestinal fistulae. We believe that NPWT of the open abdomen is a very effective treatment but could probably be improved. Springer-Verlag 2011-09-22 2012 /pmc/articles/PMC3281201/ /pubmed/21938450 http://dx.doi.org/10.1007/s00384-011-1317-2 Text en © The Author(s) 2011 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. |
spellingShingle | Original Article Hlebowicz, Joanna Hansson, Johan Lindstedt, Sandra Microvascular blood flow response in the intestinal wall and the omentum during negative wound pressure therapy of the open abdomen |
title | Microvascular blood flow response in the intestinal wall and the omentum during negative wound pressure therapy of the open abdomen |
title_full | Microvascular blood flow response in the intestinal wall and the omentum during negative wound pressure therapy of the open abdomen |
title_fullStr | Microvascular blood flow response in the intestinal wall and the omentum during negative wound pressure therapy of the open abdomen |
title_full_unstemmed | Microvascular blood flow response in the intestinal wall and the omentum during negative wound pressure therapy of the open abdomen |
title_short | Microvascular blood flow response in the intestinal wall and the omentum during negative wound pressure therapy of the open abdomen |
title_sort | microvascular blood flow response in the intestinal wall and the omentum during negative wound pressure therapy of the open abdomen |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3281201/ https://www.ncbi.nlm.nih.gov/pubmed/21938450 http://dx.doi.org/10.1007/s00384-011-1317-2 |
work_keys_str_mv | AT hlebowiczjoanna microvascularbloodflowresponseintheintestinalwallandtheomentumduringnegativewoundpressuretherapyoftheopenabdomen AT hanssonjohan microvascularbloodflowresponseintheintestinalwallandtheomentumduringnegativewoundpressuretherapyoftheopenabdomen AT lindstedtsandra microvascularbloodflowresponseintheintestinalwallandtheomentumduringnegativewoundpressuretherapyoftheopenabdomen |