Universität zu Köln

Eickhoff, Roman, Guschlbauer, Maria, Maul, Alexandra C., Klink, Christian D., Neumann, Ulf P., Engel, Michael, Hellmich, Martin, Sterner-Kock, Anja and Krieglstein, Christian F. (2019). A new device to prevent fascial retraction in the open abdomen - proof of concept in vivo. BMC Surg., 19. LONDON: BMC. ISSN 1471-2482

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Abstract

BackgroundAn open abdomen is often necessary for survival of patients after peritonitis, compartment syndrome, or in damage control surgery. However, abdominal wall retraction relieves delays and complicates abdominal wall closure. The principle of the newly fascia preserving device (FPD) is the application of anteriorly directed traction on both fascial edges over an external support through a longitudinal beam to relieve increased abdominal pressure and prevent fascial retraction.MethodsTwelve pigs were randomly divided into two groups. Both groups underwent midline laparotomy under general anesthesia. Group one was treated with the new device, group two served as controls. The tension for closing the abdominal fascia was measured immediately after laparotomy as well as at 24 and 48h. Vital parameters and ventilation pressure were recorded. Post mortem, all fascial tissues were histologically examined.ResultsAll pigs demonstrated increases in abdominal circumference. In both groups, forces for closing the abdomen increased over the observation period. Concerning the central closing force after 24h we saw a significant lower force in the FPD group (14.43N) vs. control group (21.6 +/- 5.7N, p<0.001). By testing the main effects using an ANOVA analysis we found a significant group related effect concerning closing force and abdominal circumference of the FDP-group vs. control group (p<0.001; p<0.001). The placement of the device on chest and pelvis did not influence vital parameters and ventilation pressure. Histologic exam detected no tissue damage.Conclusions This trial shows the feasibility to prevent fascial retraction during the open abdomen by using the new device. Thus, it is expected that an earlier closure of the abdominal wall will be possible, and a higher rate of primary closure will be attained.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Eickhoff, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Guschlbauer, Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Maul, Alexandra C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Klink, Christian D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Neumann, Ulf P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Engel, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Sterner-Kock, Anja UNSPECIFIED UNSPECIFIED UNSPECIFIED Krieglstein, Christian F. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-135348
DOI:	10.1186/s12893-019-0543-3
Journal or Publication Title:	BMC Surg.
Volume:	19
Date:	2019
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1471-2482
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TEMPORARY ABDOMINAL CLOSURE; PRESSURE WOUND THERAPY; COMPARTMENT SYNDROME; INTRAABDOMINAL HYPERTENSION; MANAGEMENT; WALL; COMPLICATION; SYSTEM Multiple languages Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13534