Vacuum-Assisted Closure for the Treatment of Abdominal Wounds

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Vacuum-assisted closure therapy effects on the wound

Animal studies and clinical experience have revealed several important effects on wound healing [1], [2]. The VAC device changes wound peripheral edema, blow flow, the rate of granulation tissue formation, and may change bacterial counts.

Clinical experiences with abdominal wall defects

Reconstruction of the abdominal wall can be an extraordinary difficult and high-risk procedure. Successful reconstruction is complicated by the size and location of the defect, the relative or absolute lack of viable tissue, the degree of contamination of the remaining tissue, and the overall status of these often severely injured patients. Because of the protracted, disabling morbidity of staged reconstruction, early definitive reconstruction is preferred when possible. Unfortunately,

Summary

Abdominal wall defects pose a significant surgical challenge. The defect may result from trauma, infections, previous major surgery, or some combination of these etiologies. Reconstruction has a high success rate if the abdominal wall and patient are in the best possible preoperative state. The abdominal wall should be debrided of nonviable tissue and have bacterial counts of less than 105 per gram of tissue. Bowel edema and abdominal wall edema should be controlled, so that risk of

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  • Cited by (19)

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      Benefits such as reduced odour, fewer dressing changes and fewer leakages are observed. The NPWT optimises tissue granulation, increases local blood perfusion, expands tissue nutritional supply, and decreases pathogen presence [16,17]. Intriguingly, new data verified that synthetic mesh has the ability to clear infections in the setting of MRSA [18].

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      Negative pressure therapy (NPT) was found to be an alternative open abdominal treatment in the mid-eighties, superseding e.g. sutures, clamps, the Bogota bag, zip- and Wittmann patches and other membranes for temporal closure [1–4].

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      These influences create an unfavourable ratio of beneficial growth factors and inhibitory metabolites. The application of subatmospheric pressure can remove known inhibitory wound healing factors, such as elastase and collagenase, from the wound [21,22]. Thus, local growth factors may be able to work more efficiently.

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    Wake Forest University licenses Kinetic Concepts to manufacture and market the Vacuum-Assisted Closure device. The University receives royalties from Kinetic Concepts. Dr. Argenta receives a portion of these royalties from the University.

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