NEGATIVE PRESSURE THERAPY IN COMPLEX PROGRAM FOR TREATMENT OF PANCREATOGENIC SEPSIS
https://doi.org/10.23934/2223-9022-2017-6-3-228-232
Abstract
OBJECTIVES. Critical analysis of the own first clinical results of the treatment in patients with pancreatogenic sepsis by inclusion of alternating negative pressure into the complex therapy with assessing the possibility of using NPWT as an alternative to traditional omentobursostomy.
METHODS. We report the literature data and own first clinical experience in treating patients with pancreatogenic sepsis by negative variable pressure.
RESULTS. The advantages of the negative variable pressure method are earlier arrest of systemic inflammatory response syndrome, continuous evacuation of exudate, effective cleansing of the wound cavity, stimulation of granulation tissue proliferation, reducing the risk of compartment syndrome, shortening of hospital stay in patients with a favorable outcome and improved quality of life in patients during their stay in hospital. The disadvantages of NPWT should include development of petechial and arrosive bleeding in 12.5%, the occurrence of intestinal fistulas in 12.5% of clinical observations.
CONCLUSION. Today, it is not clear what place will NPWT take in the treatment of pancreatogenic sepsis. The data obtained in the course of literature search and analysis of our own clinical experience using the method of negative pressure therapy, indicate the need to confirm the initial clinical results in further comparative randomized controlled trials.
to the complex therapy with assessing the possibility of using NPWT as an alternative to traditional omentobursostomy. Methods We report the literature data and own first clinical experience in treating patients with pancreatogenic sepsis by negative variable pressure. Results The advantages of the negative variable pressure method are earlier arrest of systemic inflammatory response syndrome, continuous evacuation of exudate, effective cleansing of the wound cavity, stimulation of granulation tissue proliferation, reducing the risk of compartment syndrome, shortening of hospital stay in patients with a favorable outcome and improved quality of life in patients during their stay in hospital. The disadvantages of NPWT should include development of petechial and arrosive bleeding in 12.5%, the occurrence of intestinal fistulas in 12.5% of clinical observations. Conclusion Today, it is not clear what place will NPWT take in the treatment of pancreatogenic sepsis. The data obtained in the course of literature search and analysis of our own clinical experience using the method of negative pressure therapy, indicate the need to confirm the initial clinical results in further comparative randomized controlled trials.About the Authors
A. Yu. AnisimovRussian Federation
Dr. Med. Sci., Dr. Med. Sci., Head of the Department for Emergency Care, Disaster Medicine and Mobilization Preparation of Healthcare, Kazan State Medical Academy – branch of the Federal State Budgetary Educational Institution of Further Professional Education «Russian Medical Academy of Continuous Professional Education»
R. A. Yakubov
Russian Federation
D. A. Beketov
Russian Federation
I. V. Halturin
Russian Federation
References
1. Savelyev V.S., Filimonov M.I., Burnevich S.Z. Pancreatic necrosis. Moscow: OOO Meditsinskoe informatsionnoe agentstvo Publ., 2008. 264 p. (In Russian).
2. Anisimov A.Yu., Andreev A.I. Prevention of vascular thrombosis of the portal system in patients with infected pancreatic necrosis. Kazanskiy meditsinskiy zhurnal, 2011. 4. 489–492. (In Russian).
3. Schintler M.V. Negative pressure therapy: theory and practice. Diabetes Metab Res Rev. 2012; 28: Suppl 1: 72–77. PMID: 22271727. DOI: 10.1002/dmrr.2243.
4. Obolenskiy V.N., Ermolov A.A., Oganesyan K.S., Aronov L.S. Vacuumassisted laparostomy in complex treatment of patient with peritonitis and internal biliary fistula. Khirurgiya. Zhurnal im NI Pirogova, 2013; 12: 91–94. (In Russian).
5. Taffurelli G., D’Ambra M., Buscemi S., et al. Vacuum Assisted Closure Therapy in Severe Acute Pancreatitis: Case Report and Literature Review. JOP. 2012; 13(5): 641. Available at: http://www.serena.unina. it/index.php/jop/ (Accessed 28 August 2017).
6. Khokonov M.A., Stupin V.A., Abramov I.S., et al. The first experience of application of Vacuum therapy in the treatment of infected pancreatic necrosis. In: Topical issues of wounds and wound infections. Wound and wound infection, materials of the interregional scientific-practical conference with international participation, October 30–31, 2013, Kazan. 142 p. (In Russian).
7. Korymasov E.A., Ivanov S.A., Krichmar A.M., et al. The application of negative pressure in the surgical treatment of patients with severe acute pancreatitis. In: Baindurashvili A.G., ed. VI Annual interregional scientific-practical conference with international participation Innovative technologies in the treatment of wounds and wound infections: proceedings of the conference, Saint Petersburg, October 22–23, 2015. Saint Petersburg: Alta Astra Publ., 2015. 160–162. (In Russian).
8. Knaus W.A., Draper E.A., Wagner D.P., Zimmerman J.E. APACHE II: A severity of disease classification system. Crit Care Med. 1985; 13(10): 818–829. PMID: 3928249.
9. Balthazar E.J. Acute pancreatitis: Assessment of severity with clinical and CT evaluation. Radiology. 2002; 223(3): 603-613. PMID: 12034923. DOI: 10.1148/radiol.2233010680.
10. Bone RC. Towards an Epidemiology and Natural History of SIRS (Systemic Inflammatory Response Syndrome). JAMA. 1992; 268(24): 3452–3455. PMID: 1460735.
Review
For citations:
Anisimov A.Yu., Yakubov R.A., Beketov D.A., Halturin I.V. NEGATIVE PRESSURE THERAPY IN COMPLEX PROGRAM FOR TREATMENT OF PANCREATOGENIC SEPSIS. Russian Sklifosovsky Journal "Emergency Medical Care". 2017;6(3):228-232. (In Russ.) https://doi.org/10.23934/2223-9022-2017-6-3-228-232