Effect Of Negative Pressure Therapy Research Articles

Effect of negative pressure therapy on the treatment response to scar thickness and viscoelasticity.

Patients with scars face a grave threat to their mental and physical health. Negative pressure has been used for scar therapy in medical care and provides a microenvironment conducive to scar healing while stimulating cell regeneration. Negative pressure may disrupt scar tissue regeneration when the pressure is too high or too low, so finding a suitable negative pressure is important. We hypothesized that different negative pressure magnitudes would affect scar tissue properties differently. This research aimed to provide practical recommendations for scar therapy. This study used three negative pressures (-105 mmHg, -125 mmHg, and -145mmHg) to compare scar material properties. We measured scar tissue thickness and viscoelasticity with a motor-driven ultrasound indentation system. According to the results of this study, scar thickness is most effectively reduced at a negative pressure of -105mmHg. In comparison, scar viscoelasticity continuously increases at a negative pressure of -125mmHg. Negative pressure therapy can be recommended to scar care clinics based on the results of this study.

The Effects of Negative Pressure Therapy on Hair Growth of Mouse Models.

Negative pressure therapy (NPT) has been shown to facilitate wound healing and promote hair growth in a porcine model. However, there is a paucity of research on the impact of negative pressure on hair growth in murine models. Despite the ability of nude mice to develop hair follicles, the hair they produce is often flawed towing to genetically induced keratin disorders, rendering them a pertinent animal model for assessing hair regeneration. Therefore, this study aims to investigate the effects of negative pressure on hair follicle growth in a nude mouse model. To achieve this, a customized external tissue expansion device was developed to apply negative pressure to the dorsum of nude mice. The mice were subjected to several treatment courses consisting of 15 and 30 min of continuous negative pressure at 10 mmHg, which were repeated 5 and 10 times every other day until sacrifice. Dorsal skin samples were subsequently extracted from the suction and nonsuction areas. The sections were stained with various antibodies to assess the expression of SOX-9, LHX-2, Keratin-15, β-catenin, CD31, and vascular endothelial growth factor-A, and a TUNEL assay was used to analyze cell apoptosis. The results showed that the number of hair follicles and angiogenesis were significantly higher in the suction area than in the nonsuction area in all groups. Moreover, mice that received NPT for 15 min for 10 times had a higher hair follicle density than the other three groups. Immunofluorescence staining for LHX-2 and Keratin 15 further validated the results of these findings. In conclusion, this study demonstrated that negative pressure effectively promotes hair follicle growth and angiogenesis in nude mice through SOX-9- and LHX-2-mediated follicular regeneration and β-catenin-mediated hair follicle morphogenesis.

Evidence for the benefits of negative pressure therapy in the treatment of diabetic foot in adults: a comprehensive approach to improved health

Diabetic foot ulcers represent an increase in recent years in the cures to be carried out by nursing staff. For this reason, the new negative pressure therapy has been chosen, which involves an increase in granulation tissue, leading to complete healing in a minimum time, highlighting the few complications derived from said therapy. Objective: To demonstrate the effectiveness of negative pressure therapy in patients with diabetic foot. Methodology: A narrative review was carried out between December 2022 and November 2023 in the databases of Pubmed, Dialnet, Google Scholar, WOS, Scopus and Cochrane, following a search string, which combines keywords derived from the thesauri “Health Sciences Descriptors” (DeCS) and “Medical Subject Headings” (MeSH), being combined with the Boolean operators “NOT”, “OR” and “AND”. Results: Negative pressure therapy offers a number of significant benefits for adult patients with diabetic foot, improving wound healing, reducing the risk of serious complications and contributing to a better quality of life. It is important to highlight that the implementation of this therapy must be guided by health professionals and adapted to the specific needs of each patient. Conclusion: After comparing the different selected articles, it was determined that the application of negative pressure therapy in diabetic foot ulcers is beneficial in relation to the reduction in healing time compared to conventional wound healing dressings. The associated complications being minimal. Furthermore, treatment with this therapy turns out to be cost-effective by reducing patients' hospital stays, leading to an increase in quality of life.

The effectiveness of negative pressure therapy in burns: scoping review

The effectiveness of negative pressure therapy in burns: scoping review

The effectiveness of negative pressure wound therapy compared to the traditional method in the treatment of diabetic foot

Introduction and objective: Diabetes is one of the most common metabolic diseases in the world. Diabetic foot ulcers, which are often the result of the disease, are undoubtedly a nursing challenge. Negative pressure wound therapy (NPWT) is a new therapeutic method supporting wound healing, which has been useful in patients with diabetic foot. The purpose of this study is to compare the effectiveness of negative pressure therapy in comparison to the standard method in the treatment of diabetic foot. Review methods: In February 2023, articles found in the Medline (Pubmed) and Google Scholar databases were selected by using the following keywords: negative pressure wound therapy; VAC therapy; traditional dressing; standard moist wound care; diabetic foot. Brief description of the state of knowledge: NPWT has been proven to be associated with reduced healing time and faster appearance of granulation tissue, which is a sign of wound healing. Patients using this method require fewer dressing changes and surgical cleanings. Negative pressure therapy reduces the time to rehospitalisation and the risk of amputation or resection of the diabetic foot. Summary: Negative pressure wound therapy is more effective in the treatment of diabetic foot ulcers than traditional therapy. Despite the costs associated with NPWT being higher, the method proves to be more profitable. It is important to remember about good therapy technique and proper selection of patients.

The Effectiveness of Negative Pressure Therapy: Nursing Approach.

Complex wounds require advanced techniques for their management and care. Wound care costs are high, so healthcare professionals need to be aware of available therapies. Negative pressure therapy is a technology for which more and more data on its effectiveness in complex wounds are being collected. The objectives of this review were to analyze if the application of negative pressure therapy in complex wounds is effective; to compare the effectiveness of negative pressure therapy with other conventional treatments, as well as its combination with other therapies; and to evaluate the quality of life of patients undergoing negative pressure therapy and collect their main characteristics. A bibliographic review focused on articles published between November 2015 and June 2022 was carried out. The following databases were consulted: PubMed (Medline), Google Scholar, Web of Science (WOS), Scielo and Scopus. The most used pressures in the studies coincide at -125 mmHg and in the range of -125 mmHg to -150 mmHg. In the pediatric population, pressure levels vary by age group. A pressure of -75 to -125 mmHg is recommended for children over 12 years of age, and -50 to -75 mmHg is recommended for children under 2 years of age. Negative pressure therapy stands out for its rapid rate of granulation, the prevention and effective treatment of infections, the variety and malleability of dressings, its various applications and the possibility of using it with other therapies to accelerate wound closure.

Вплив терапії негативним тиском на процеси запалення та регенерації в ранньому періоді загоєння вогнепальних ран кінцівок

Вакуум-асистоване закриття рани (VAC) проявило себе як економічно вигідний та ефективний метод лікування протягом останніх двох десятиліть, але різноманіття отриманих пацієнтами ушкоджень тканин при вогнепальних (у т.ч. бойових) травмах вимагає подальшого дослідження впливу негативного тиску на процес загоєння рани. Метою дослідження був комплексний аналіз ефективності вакуумної терапії рани (VAC) у взаємозв’язку зі змінами показників лейкоцитарної формули та цитограм із ранового вмісту у хворих із тяжкими вогнепальними ранами. Було виявлено, що VAC пришвидшує зміну дегенеративно-некротичного типу цитограм із ранового вмісту на регенераторний, прискорює нормалізацію показників лейкоцитограми внаслідок зменшення обсягу некробіотичних процесів, підвищує концентрацію судинного ендотеліального фактора росту (VEGF) у сироватці крові, значно зменшує відсоток гнійно-септичних ускладнень, скорочує терміни підготовки ран до реконструктивних оперативних заходів у хворих із застосуванням негативного тиску в середньому на 5,2 ± 0,8 доби.

Vacuum-Assisted Suction Drainage as a Successful Treatment Option for Postoperative Symptomatic Lymphoceles.

Lymphoceles often occur within several weeks or even months after surgery. Mostly asymptomatic and therefore undiagnosed, they may be self-healing without any treatment. A small percentage of postoperative lymphoceles are symptomatic with significant pain, infection, or compression of vital structures, thus requiring intervention. Many different treatment options are described in the literature, like drainage with or without sclerotherapy, embolization of lymph vessels, and surgical approaches with laparoscopy or laparotomy. Inspired by reports stating that postoperative suction drainage can prevent the formation of lymphoceles, we developed a simple protocol for vacuum-assisted drainage of symptomatic lymphoceles, which proved to be successful and which we would therefore like to present. Between 2008 and 2020, 35 patients with symptomatic postoperative lymphoceles were treated with vacuum-assisted suction drainage (in total 39 lymphoceles). The surgery that caused lymphocele formation had been performed between 8 and 572 days before. All lymphoceles were diagnosed based on biochemical and cytologic findings in aspirated fluid. The clinical and imaging data were collected and retrospectively analyzed. In total, 43 suction drainage catheters were inserted under CT guidance. The technical success rate was 100 %. One patient died of severe preexisting pulmonary embolism, sepsis, and poor conditions (non-procedure-related death). In 94.8 % of symptomatic lymphoceles, healing and total disappearance could be achieved. 4 lymphoceles had a relapse or dislocation of the drainage catheter and needed a second drainage procedure. Two lymphoceles needed further surgery. The complication rate of the procedure was 4.6 % (2/43, minor complications). The median indwelling time of a suction drainage catheter was 8-9 days (range: 1-30 days). The positive effects of negative pressure therapy in local wound therapy have been investigated for a long time. These positive effects also seem to have an impact on suction drainage of symptomatic lymphoceles with a high cure rate. · Suction drainage of lymphoceles is an easy and successful method to cure symptomatic lymphoceles at various locations.. · We believe this to be due to the induction of cavity collapse and surface adherence.. · In most cases rapid clinical improvement could be obtained.. · Franke M, Saager C, Kröger J et al. Vacuum-Assisted Suction Drainage as a Successful Treatment Option for Postoperative Symptomatic Lymphoceles. Fortschr Röntgenstr 2022; 194: 384 - 390.

Preliminary Analysis of Negative Pressure to Prevent Lower Extremity Amputation Wound Complications: Pilot Data From a Randomized Clinical Trial

Lower extremity amputation incision complications contribute significantly to patient morbidity and increase healthcare costs. In a previous randomized clinical trial, we demonstrated the beneficial effect of negative pressure therapy for closed groin incisions in reducing complications. The present study prospectively evaluated negative pressure dressing as a method to decrease the incidence of wound complications related to major lower extremity amputations.

Effect of Negative Pressure Therapy versus Polarized Light Therapy on Chronic Wound Healing

Abstract Background: Chronic wounds are wounds that have failed to proceed through the normal process of healing. There are varying etiologies of chronic wounds, which all create a burden upon the health care system. Aim of Study: The aim of this study was to investigate the difference in the effect between negative pressure therapy and polarized light therapy on chronic wound healing. Patients and Methods: Thirty patients were diagnosed by a physician as chronic wound patients (grade 2 and 3). Their age ranged from 45 to 65 years. Patientswere selected from Cairo University Hospitals. They were distributed randomly into two groups (A, B) equal in numbers. Group A received negative pressure therapy daily with dressings changes 3 times a week with the traditional medical treatment for 6 weeks. Group B received polarized light therapy for 10min 3 times aweek with the traditional medical treatment for 6 weeks. Wound surface area and wound volume were assessed by tracing method and saline respectively pretreatment, 3 weeks and 6 weeks after treatment.The study was carried out from July 2020 to October 2020. Results: There were no significant difference in wound surface area and wound volume between groups pre-treatment (p>0.05). Comparison between both groups post-treatment revealed a non-significant difference in wound surface area and wound volume at post I (p>0.05); however, there were a significant decrease in wound surface area (p=0.02) and wound volume (p=0.01) of group A compared with that of group B at post II. Conclusion: These results suggested that negative pressure therapy was more effective than polarized light therapy in reducing surface area and wound volume of chronic wound.

Effect of Negative Pressure Therapy on Open Abdomen Treatments. Prospective Randomized Study With Two Commercial Negative Pressure Systems.

Introduction: The use of negative pressure dressings for open abdominal therapy has made a great impact on strategies for open abdominal treatment. Observed intestinal damage and developement of fistula formation raises questions about safety of commonly used systems (AB-Thera). The most common used system uses foils for shielding intestines directly from negative pressure. As an alternative a system with open pore dressing in double layer film was introduced (Suprasorb CNP) and proved to safe in animal studies. We compared the effects of this two systems on patients requiring open abdominal treatment.Materials and methods: Patients with secondary peritonitis in at least two abdominal quadrants were included in this randomized study. Inclusion criteria were secondary peritonitis (ACS), abdominal compartment syndrome, and abdominal trauma combined with ACS and/or contaminated abdomen. Patients with active bleeding and pancreatitis were not included. We examined Mannheim peritonitis Index (MPI), bloodcount, PCT, amount of fluid collected, and morphological changes on the bowel. Data were collected on day 2, 4, 7, 14, 21, and 28. Primary end point was fascial closure. Examination was terminated in case of death and damage to the abdominal organs. Groups were compared using Mann Whitney U-test and chi square test. Trend evaluation was evaluated using an one way repeated measure analysis of variance. P-values below 0.05 was considered significat.Results: Thirty four patients were included between August 2010 and September 2012. There were no significant difference between two groups in MPI, age, and gender. Mean duration of treatment, WBC, CRP, and abdominal closure rate were not significantly different between groups. Suprasorb CNP System collected twice more fluid than AB-Thera and decreased PCT on significantly faster rate than AB-Thera. Four patients died (11%) and four patients developed enteric fistula (11%). Closure rate was achieved in 27 out of 34 Patients (79.5%). Closure rate was not significantly different between groups.Conclusion: The use of both systems proved to be efficient and safe. The application of well-dosed, moderate negative pressure on contaminated areas of the abdomen seems to have a lot of potential and it is worth directing greater research potential in this direction.

Negative Pressure Therapy Versus Conventional Dressing for Management of Anastomotic Leak After Transhiatal Esophagectomy

Transhiatal esophagectomy (THE) with cervical esophagogastric anastomosis is done for esophageal carcinoma and various benign lesions of the esophagus. Cervical anastomotic (CA) leak following THE is a serious complication that adds significantly to morbidity. As these leaks usually manifest in neck, local wound care is one of the essential components to manage such leaks. This study aims to evaluate the effect of negative pressure therapy (NPT) on healing of cervical wound following CA leaks. The record of all patients, who underwent THE for benign or malignant lesion of the esophagus from 2012 to 2019, was retrospectively analyzed. Of all the patients who had CA leak, patients with type II CA leak were only included for further analysis. The outcome of the patients who received NPT for wound care was compared with those who received simple wound dressings in terms of time to oral feed, hospital stay, mortality, and dysphagia at 6 months. Seventy-two patients were thus identified and 18 (25%) had an anastomotic leak. Patients with type II leaks (n = 16) were successfully managed by conservative approach. NPT for wound care in these patients was associated with significant reduction in hospital stay and early resumption of oral intake (p < 0.05) as compared with simple wound dressings. Conservative approach is effective for management of CA leaks. NPT for wound care significantly reduces associated morbidity.

The Effect of Negative Pressure Therapy on Closed Wound After the Orthopedic Surgery of Lower Limb: A Meta-Analysis

Background. Negative-pressure wound therapy is applied increasingly to manage closed wounds. However, no consensus has been reached with regard to surgical site infection and wound complication. Aim. To evaluate the effect of negative pressure therapy on closed wounds after orthopedic surgeries. Methods. PubMed, EMBASE, Cochrane Library, and MEDLINE databases were searched from 1966 to January 2019; the references in the identified studies were also searched. Results. Ten studies on arthroplasty and 3 studies on fractures were included. Significantly few infections appeared in the negative pressure group (odds ratio [OR] = 0.28, 95% confidence interval [CI] = 0.18-0.46, P < .001; I2 = 0%, P = .80). There was no significant difference for other complications (OR = 0.54, 95% CI = 0.21-1.39, P = .20; I2 = 81%, P < .001). Few patients needed reoperation in the negative pressure group (OR = 0.28, 95% CI = 0.14-0.53, P < .001; I2 = 0%, P = .82). Conclusion. Negative pressure therapy can decrease surgical site infection and reoperation of closed incisions.

Effects of negative-pressure therapy with and without ropivacaine instillation in the early evolution of severe peritonitis in pigs.

The abdomen is the second most common source of sepsis and secondary peritonitis, which likely lead to death. In the present study, we hypothesized that instillation of local anesthetics into the peritoneum might mitigate the systemic inflammatory response syndrome (SIRS) in the open abdomen when combined with negative-pressure therapy (NPT) to treat severe peritonitis. We performed a study in 21 pigs applying a model of sepsis based on ischemia/reperfusion and fecal spread into the peritoneum. The pigs were randomized into three groups, and treated for 6h as follows: Group A: temporary abdominal closure with ABTHERA™ Open Abdomen Negative-Pressure Therapy; Group B: temporary abdominal closure with ABTHERA™ Open Abdomen Negative-Pressure Therapy plus abdominal instillation with physiological saline solution (PSS); and Group C: temporary abdominal closure with ABTHERA™ Open Abdomen Negative-Pressure Therapy plus peritoneal instillation with a solution of ropivacaine in PPS. A comparison between the three groups revealed no statistically significant difference for any of the parameters registered (p > 0.05), i.e., intra-abdominal pressure, blood pressure, heart rate, O2 saturation, diuresis, body temperature, and blood levels of interleukin 6 (IL-6), tumor necrosis factor alpha (TNFα), and c-reactive protein (CRP). In addition, histological studies of the liver, ileum, kidney and lung showed no difference between groups. The use of abdominal instillation (with or without ropivacaine) did not change the effect of 6h of NPT after sepsis in animals with open abdomen. The absence of adverse effects suggests that longer treatments should be tested.

Negative Pressure Therapy in the Regeneration of the Sciatic Nerve Using Vacuum - Assisted Closure in a Rabbit Model.

BackgroundThe aim of this study was to investigate the effects of negative pressure therapy in the regeneration of the rabbit sciatic nerve using vacuum assisted closure (VAC).Material/MethodsThirty male New Zealand white rabbits underwent surgical injury of the sciatic nerve, followed by negative pressure therapy using vacuum assisted closure (VAC), in three treatment groups: Group A: 0 kPa; Group B: −20 kPa; Group C: −40 kPa. At 12 weeks following surgery, the following factors were studied: motor nerve conduction velocity (MNCV); the number of myelinated nerve fibers; the wet weight of the gastrocnemius muscle. Gastrocnemius muscle and sciatic nerve tissue samples were studied for the expression of S100, and brain-derived neurotrophic factor (BDNF) using Western blot.ResultsAt 12 weeks following VAC treatment, the MNCV, number of myelinated nerve fibers, and wet weight of the gastrocnemius muscle showed significant differences between the groups (p<0.05), in the following order: Group B >Group A >Group C. The sciatic nerve at 12 weeks following VAC in Group B and Group C showed a significant increase in expression of S100 and BDNF when compared with Group A; no significant differences were detected between Group B and Group C results from Western blot at 12 weeks.ConclusionsThe findings of this study, using negative pressure therapy in VAC in a rabbit model of sciatic nerve damage, have shown that moderate negative pressure was beneficial, but high values did not benefit sciatic nerve repair.

Negative pressure wound therapy inhibits inflammation and upregulates activating transcription factor-3 and downregulates nuclear factor-κB in diabetic patients with foot ulcerations.

Negative pressure wound therapy (NPWT) is one of the most important treatments for diabetic foot, but the underlying mechanisms of its benefits still remain elusive. This study aims to evaluate the inflammatory signals involved in the effects of negative pressure therapy on diabetic foot ulcers. We enrolled 22 patients with diabetic foot ulceration, 11 treated with NPWT and the other 11 treated with traditional debridement. All patients were treated and observed for 1week. Granulation tissues were harvested and analyzed in both groups, and then were histologically and immunohistochemically analyzed. Enzyme-linked immunosorbent assay, Western blot analysis, and real-time PCR were performed to evaluate the expression of interleukin-6 (IL-6), tumor necrosis factor α (TNF-α), inducible nitric oxide synthase (iNOS), nuclear factor-κB (NF-κB) p65, Ik B-α, and activating transcription factor-3 (ATF-3). After 7days of treatment, NPWT could obviously promote diabetic wound healing because of the mild inflammation and the dense cell-deposited matrix. Meanwhile, NPWT significantly decreased the expression of TNF-α, IL-6, and iNOS (all P<.05). The result of Western blotting and real-time PCR indicated that NPWT obviously decreased the level of Ik B-α and NF-κB p65, and increased the level of ATF-3 (all P<.05). NPWT exerts an anti-inflammatory effect, possibly through the suppression of proinflammatory enzymes and cytokines resulting from Ik B-α inhibition and ATF-3 activation, which may prevent the activation of the NF-κB pathway in human diabetic foot wounds.

Negative pressure therapy for the treatment of complex wounds.

The objective of this study is to evaluate the effectiveness of negative pressure therapy (NPT) in the treatment of complex wounds, with emphasis on its mechanisms of action and main therapeutic indications. We searched the Pubmed / Medline database for articles published from 1997 to 2016, and selected the most relevant ones. The mechanisms of action of NPT involveboth physical effects, such as increased perfusion, control of edema and exudate, reduction of wound dimensions and bacterial clearance, and biological ones, such as the stimulation of granulation tissue formation, microdeformations and reduction of Inflammatory response. The main indications of NPT are complex wounds, such as pressure ulcers, traumatic wounds, operative wound dehiscences, burns, necrotizing wounds, venous ulcers, diabetic wounds, skin grafts, open abdomen, prevention of complications in closed incisions and in the association with instillation of solutions in infected wounds.

The Effectiveness of Negative Pressure Therapy in Diabetic Foot Ulcers with Elevated Protease Activity: A Case Series.

Objective: Despite several works have described the usefulness of negative pressure therapy (NPT) in the treatment of diabetic foot ulcers (DFUs), no studies have reported its ability in the proteases modulation in DFUs. The aim of this work was to evaluate the role of NPT as a protease-modulating treatment in DFUs. Approach: We conducted a prospective study of a series of diabetic patients affected by chronic DFUs. Each ulcer was assessed for matrix metalloproteinases (MMPs) activity with a protease status diagnostic test at the baseline and after 2 weeks of NPT. Results: Four patients were included. All patients had type 2 diabetes with a disease duration of ≈20 years. A1c was 79.5 ± 15.3 mmol/mol. Ulcer area was >5 cm2 in all cases. All wounds showed elevated protease activity (EPA) at the baseline. After 2 weeks, all patients showed a normalization of MMPs activity. Innovation: NPT showed its effectiveness in the reduction of EPA in chronic DFUs. Conclusion: This study confirms the role of NPT in the positive modulation of protease activity also in chronic DFUs.

Evalution of the effectiveness of VAC-therapy in the preparatory stage of plastic wound closure in patients with diabetic foot

Purpose – to evaluate the efficiency of topical negative pressure wound therapy (NPWT) in comparison to standard therapy in post operative wounds in patients with diabetic foot syndrome.Materials and methods. The effects of negative pressure therapy on the clinical (size, tissue oxygenation), histological (light microscopy), morphometric and immunohistochemical (eNO synthase) aspects of repair of the soft tissue of the lower extremities in patients with diabetes mellitus in comparison with standard treatment. 60 patients with diabetic foot syndrome were included in the study from the moment of debridement till the plastic closure of the wound. During the perioperative period, 28 patients received NPWT (-50 to -120 mmHg) and 32 patients received standard therapy.Results and discussion. A reduction of the wound area by (24,6+12,2)% was achieved with negative pressure therapy compared with baseline data. In the control group, the corresponding values were (12,5+-11,4)%. The results of transcutaneous oximetry showed a greater increase in the level of local micro hemodynamics in the study group as compared to the control group (p &lt;0,05). An important criterion of wound preparation, for plastic closure of the wound is filling it with granulation tissue by more than 75%. 94% of the patients in the study group had (82,1% +-16)% of their wound filled with granulation tissue. The histological data of the study group showed a significant reduction of oedema by 80% (p &lt;0,05), improved extracellular matrix organization (p &lt;0,05), 90% (p &lt;0,05) dissolution of inflammatory infiltrate and the formation of healthy granulation tissue (p&lt;0,05). Immunohistochemical analysis demonstrated a significant increase in the number of fibroblasts in the dermis (p &lt;0,05), increased expression of eNO synthase.Conclusions. The findings suggest that negative pressure therapy (-50 to -120 mmHg) is more efficient compared with standard treatment and achieves more rapid reduction of the area and depth of the wound, increased local microcirculation and decreased inflammation. These findings were confirmed histologically and immunohistochemically. The high efficiency of this method significantly reduced the time required for preparing the wound for autodermoplasty.

Intra-abdominal Pressure Monitoring in Open Abdomen Management with Dynamic Abdominal Closure.

The importance of elevated intra-abdominal pressure (IAP) and abdominal compartment syndrome (ACS) have been recognized in critical care for its potential damaging effects. But, quantification of IAP values may be useful as a clinical tool for determining efficacy of coughing and straining for functional recovery of OA patients. We would like to evaluate IAP generated in an OA patient and the effect of negative pressure therapy (NPT) and dynamic abdominal closure systems (ABRA) on the IAP values at rest and during coughing and straining and compare those with IAP measurements of closed abdomen after standard open elective colorectal surgery (non-OA). Eight OA and eight non-OA patients were included in this study. OA patient with NPT and ABRA (OA + NA), OA patient without NPT and ABRA completely unbraced (OA-NA) (NA stands for NPT and ABRA), and non-OA patients underwent IAP measurements at rest, during coughing, and during straining via transurethral catheter. There was no difference in the mean of IAP measurement at rest in OA-NA (6.1mmHg), OA + NA (6.5mmHg), and non-OA (6.0mmHg) patients. During coughing, IAP of OA-NA, OA + NA, and non-OA patients were 11.5, 19.1, and 22.0mmHg and during straining, IAP of OA-NA, OA + NA, and non-OA patients were 11.5, 17.5, and 23.5mmHg, respectively. Application of NPT in conjunction with ABRA did not increase IAP at rest but provided significant IAP increase in OA + NA patients, when compared to OA-NA patients during coughing and straining. NPT in conjunction with ABRA offers the advantage of increase of IAP during coughing and straining.