Negative Pressure Therapy in Abdominal Compartment Syndrome

Abstract

The abdominal vacuum-assisted closure (VAC) system has been introduced, providing a new possibility to treat an open abdomen. Abdominal compartment syndrome has a great relevance in surgical practice and patient care in critical condition due to the effects of increased pressure in the enclosed space of the abdomen can lead to multiple organ failure. A prospective study was conducted on a sample of 15 patients with severe acute pancreatitis (SAP) was retrospectively analyzed, following the incidence of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS),the effectiveness of the therapeutic methods applied in reducing the intra-abdominal pressure (PIA), the evolution of severity scores, lenght of stay in intensive care unit between January 2014 - March 2017, following negative pressure therapy. There were used vacuum assisted closure devices (VAC � -Hartman) in order to apply negative pressure to the open abdomen, while complying with specified settings in accordance with patients� outcome. Surgery for abdominal decompression in PAS with SCA is an emergency and was imposed on 14 of the 15 patients . In the studied group, the first decompression procedure was performed on days 2 to 5 from intake, as PIA increased in evolution despite medical methods. Only 1 patient hospitalized with SAP PIA decreased by medical methods and after haemofiltration. Acute severe pancreatitis remains a serious pathology in spite of a maximum medical and surgical therapy.Continuous venous haemofiltration has contributed to lowering intraabdominal pressure. Surgery with decompression vacuum systems with negative pressure lead to a significant decrease in PIA.