Macroscopic changes during negative pressure wound therapy of the open abdomen using conventional negative pressure wound therapy and NPWT with a protective disc over the intestines

Twelve pigs underwent midline incision. Six animals underwent conventional NPWT, while the other six pigs underwent NPWT with a protective disc inserted between the intestines and the vacuum source. Macroscopic changes were photographed and quantified after 12, 24, and 48 hours of NPWT.The surface of the small intestines was red and mottled as a result of petechial bleeding in the intestinal wall in all cases. After 12, 24 and 48 hours of NPWT, the area of petechial bleeding was significantly larger when using conventional NPWT than when using NPWT with the protective disc (9.7 ± 1.0 cm2 vs. 1.8 ± 0.2 cm2, p < 0.001, 12 hours), (14.5 ± 0.9 cm2 vs. 2.0 ± 0.2 cm2, 24 hours) (17.0 ± 0.7 cm2 vs. 2.5 ± 0.2 cm2 with the disc, p < 0.001, 48 hours)The areas of petechial bleeding in the small intestinal wall were significantly larger following conventional NPWT after 12, 24 and 48 hours, than using NPWT with a protective disc between the intestines and the vacuum source. The protective disc protects the intestines, reducing the amount of petechial bleeding.An injury to the abdomen or abdominal surgery can result in a wound that cannot be closed immediately. It may be necessary to leave the wound open to allow further treatment, or to allow infection to clear. In this type of open abdomen, laparostomy, the internal organs, including the bowel, may be exposed. Treatment of laparostomy with negative pressure wound therapy (NPWT) for abdominal sepsis and abdominal compartment syndrome has resulted in a high rate of successful abdominal closure. In addition, patients recover more rapidly. In patients with abdominal compartment syndrome, decompressed laparotomy with temporary closure with NPWT might be crucial, whereas in abdominal sepsis and peritonitis NPWT's draining effect and reduction of bacterial load is thought to be of great importance [1-3]. The primary goals of NWPT of the open abdomen include the avoidance of mechanical contamination of abdominal viscera, active remova