title: Microvascular blood flow changes in the small intestinal wall during conventional negative pressure wound therapy and negative pressure wound therapy using a protective disc over the intestines in laparostomy.
abstract: OBJECTIVE
  Blood flow changes in the intestines during conventional negative pressure wound therapy (NPWT), and NPWT using a protective disc over the intestines in laparostomy.
  
  
  BACKGROUND
  Higher closure rates of the open abdomen have been reported with NPWT compared with other kinds of wound management. However, the method has been associated with increased development of fistulae. We have compared the changes in blood flow in the intestinal wall using conventional NPWT and NWPT with a protective disc between the intestines and the vacuum source.
  
  
  METHODS
  Midline incisions were made in 10 pigs and either conventional NPWT or NPWT with a disc over the intestines was applied. The microvascular blood flow was measured in the intestinal wall before and after the application of topical negative pressures of -50, -70, and -120 mmHg, using laser Doppler velocimetry.
  
  
  RESULTS
  The blood flow was significantly decreased (by 24%) after the application of conventional NPWT at -50 mmHg, compared with a slight decrease (2%) after the application of NWPT with a protective disc (P < 0.05). The blood flow was significantly decreased (by 54%) after the application of conventional NPWT at -120 mmHg, compared with a slight decrease (17%) after application of NPWT using a protective disc (P < 0.001).
  
  
  CONCLUSIONS
  Inserting a disc between the intestines and the vacuum source in NPWT protects the intestines from ischemia. The decreased blood flow in the intestinal wall may induce ischemia, which could promote the development of intestinal fistulae.
authors: Department of Cardiothoracic Surgery, Lund University and Skåne University Hospital, Lund, Sweden. sandra.lindstedt@skane.se
authors: Sandra
authors: S
authors: Lindstedt
authors: Malin
authors: M
authors: Malmsjö
authors: Johan
authors: J
authors: Hansson
authors: Joanna
authors: J
authors: Hlebowicz
authors: Richard
authors: R
authors: Ingemansson
mesh_terms: D000818:Animals; D001672:Biocompatible Materials; D004195:Disease Models, Animal; D005260:Female; D007421:Intestine, Small / Q000098:blood supply*; D007511:Ischemia / Q000503:physiopathology* / Q000517:prevention & control*; D017078:Laser-Doppler Flowmetry; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D013552:Swine
chemical_list: D001672:Biocompatible Materials