Negative Pressure Wound Therapy Journal 2020-03-31T21:36:01+02:00 Wojciech Francuzik Open Journal Systems <p>Diamond Open Access, peer-reviewed academic journal focused on the use of vacuum therapy.&nbsp;</p> <p>&nbsp;</p> Deferred anastomosis in severe secondary peritonitis using a temporary intestinal shunt – a case report 2020-03-31T19:37:11+02:00 Ignacio Rey-Simó Alejandra García-Novoa Jessica Correa-Marín Alden Pool Gómez-Alférez <p>Introduction: As part of the damage control surgery concept applied to the treatment of sepsis due to severe secondary peritonitis following intestinal perforation and/or in high-risk patients we describe the novel "temporary intestinal shunt" (TIS) technique with delayed intestinal anastomosis, as an alternative to primary anastomosis or enterostomy.<br>Material and Methods: We present three patients in whom urgent laparotomy was performed due to intestinal perforation, with intestinal resection and TIS.<br>Case reports:<br>1) CASE 1: A 39-year-old male presented with acute myeloid leukemia M3 and generalized peritonitis, sigmoid colon perforation and secondary jejunal loop involvement. In view of these findings, we performed 10 cm jejunal resection with TIS placement, sigmoid colon resection, and negative pressure therapy (NPT). Reoperation after 48 hours showed no evidence of peritonitis, so a manual jejuno-jejunal anastomosis and terminal colostomy were performed.<br>2) CASE 2: A 65-year-old woman treated with corticosteroids presented with a pneumoperitoneum secondary to a road trac accident. Urgent laparotomy revealed a 2 cm jejunal perforation. Resection of the jejunal segment and TIS with NPT was performed. Exploration of the peritoneal cavity 96 hours later showed a clinical improvement and a jejuno-ileal anastomosis was performed.<br>3) CASE 3: A 73-year-old male was admitted due to intestinal subocclusion. Clinical deterioration occurred rapidly and we performed an urgent laparotomy diagnosing jejunal perforation secondary to torsion and ischemia of the a ected loop, and generalized peritonitis. Intestinal resection and TIS with NPT placement were thus decided. Anastomosis and closure of the abdominal appendage were deferred until 96 hours after the first surgery.<br>Conclusion: Although the evidence we present is limited, we believe TIS to be an additional tool in damage control surgery. This staged management strategy allows definitive reconstruction with the patient in a more favorable physiological condition.</p> 2020-03-31T19:16:40+02:00 Copyright (c) 2020 Ignacio Rey-Simó, Alejandra García-Novoa, Jessica Correa-Marín, Alden Pool Gómez-Alférez Novel, self-made and cost-ective technique for closed-incision negative pressure wound therapy 2020-03-31T21:36:01+02:00 Dominik Andrzej Walczak Maciej Grajek Marcin Zeman Tomasz Pałka Mathias Kalkum Mirosław Dobrut Piotr Drozdowski Rafał Ulczok Karolina Donocik Adam Maciejewski Łukasz Krakowczyk <p>Background: It has been suggested that applying the negative pressure wound therapy (NPWT) to a closed<br>surgical incision may hasten the healing of the incision and decrease the incidence of wound healing complications. The goal of this study is to present the new idea of a simple, self-made, low-cost wound vacuum dressing for closed-incision NPWT that may become an alternative to currently manufactured medical<br>industry products.<br>Method: We designed a simple dressing for closed-incision NPWT from gauze pads, polyurethane adhesive film, stoma paste, and a drain tube. Negative pressure was created using a standard 50 ml syringe connected to the drain. First, the dressing was applied to the wound model and on the healthy volunteer. Finally, the dressing was applied to 10 patients after low anterior rectal resection. The vacuum dressing was left in place for 3 days, then changed and placed once more for the next 3 days.<br>Results: We did not observe any adverse effects associated<br>with the dressing. All postoperative wounds healed properly. 18 out of 20 dressings were still air-tight 72h post-placement.<br>Conclusions: This simple, self-made dressing for NPWT is safe and effective and may decrease the wound infection rate. However future studies are needed to confirm that hypothesis.</p> 2020-03-31T19:15:32+02:00 Copyright (c) 2020 Dominik Andrzej Walczak, Maciej Grajek, Marcin Zeman, Tomasz Pałka, Mathias Kalkum, Mirosław Dobrut, Piotr Drozdowski, Rafał Ulczok, Karolina Donocik, Adam Maciejewski, Łukasz Krakowczyk