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Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-4055

Benninger, E; Labler, L; Seifert, Burkhardt; Trentz, O; Menger, M D; Meier, C (2008). In vitro comparison of intra-abdominal hypertension development after different temporary abdominal closure techniques. Journal of Surgical Research, 144(1):102-106.

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Abstract

BACKGROUND: To compare volume reserve capacity (VRC) and development of intra-abdominal hypertension after different in vitro temporary abdominal closure (TAC) techniques. METHODS: A model of the abdomen was designed. The abdominal wall was simulated with polychloroprene, a synthetic rubber compound. A lentil-shaped defect of 150 cm(2) was cut into the anterior aspect of the abdominal wall. TAC of this defect was performed by a zipper system (ZS), a bag silo closure (BSC), or a vacuum assisted closure (VAC) with subatmospheric pressures ranging from 0- to 200 mmHg. The model with intact abdominal wall served as reference. The model was filled with water to baseline level. The intra-abdominal pressure was increased in 2 mmHg steps from baseline level (6 mmHg) to 40 mmHg by adding volume to the system according to a standardized protocol. VRC with corresponding intra-abdominal pressure were analyzed and compared for the different TAC techniques. RESULTS: VRC was the highest after BSC at all pressure levels studied (P < 0.05). VAC and ZS resulted in significantly lower VRC compared with BSC and reference (P < 0.05). The magnitude of negative pressure on the VAC did not significantly influence the VRC. CONCLUSIONS: In the present in vitro model, BSC demonstrated the highest VRC of all evaluated TAC techniques. Different levels of subatmospheric pressures applied to the VAC did not affect VRC. The results for ZS and VAC indicate that these TAC techniques may increase the risk for recurrent intra-abdominal hypertension and should therefore not be used in high-risk patients during the initial phase after abdominal decompression.

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > University Hospital Zurich > Division of Surgical Research
DDC:610 Medicine & health
Language:English
Date:2008
Deposited On:17 Nov 2008 09:16
Last Modified:14 Mar 2014 14:32
Publisher:Elsevier
ISSN:0022-4804
Publisher DOI:10.1016/j.jss.2007.02.021
PubMed ID:17764694
Citations:Web of Science®. Times Cited: 8
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