NPWT-therapy in complex treatment of pancreatogenic sepsis
R.A. YAKUBOV1, D.A. BEKETOV1, I.V. KHALTURIN1, A.Yu. ANISIMOV2
1Emergency Hospital, 18 Naberezhnochelninsky Pr., Naberezhnye Chelny, Russian Federation, 423800
2Kazan State Medical Academy — Branch Campus of the FSBEI FPE RMACPE MOH Russia, 36 Butlerov Str., Kazan, Russian Federation, 420012
Yakubov R.A. ― Head of the Vascular Surgery Department, tel. +7-917-243-37-26, e-mail: ramsesj@yandex.ru
Khalturin I.V. ― surgeon of the Surgery Department №2, tel. +7-986-934-69-44, e-mail: shweps66@yandex.ru
Beketov D.A. ― surgeon of the Surgery Department №1, tel. +7-987-287-03-88, e-mail: dim.beketov@yandex.ru
Anisimov A.Yu. ― D. Med. Sc., Professor, Head of the Department of Emergency Medical Aid, Medicine of Catastrophes and Mobilization Training, tel. +7-987-297-16-54, e-mail: aanisimovbsmp@yandex.ru
Critical analysis has been conducted of the first clinical results of the treatment of 8 patients with pancreatogenic sepsis by inclusion of the NPWT method as an alternative to traditional omentobursostomy. The disadvantages of NPWT method include the development of petechial and arosive bleeding in 12.5%, the occurrence of intestinal fistula in 12.5% of clinical observations. Today, it is still not clear if the NPWT method will occupy its firm position in the treatment algorithm of patients with pancreatogenic sepsis. The data obtained in the course of literature search and analysis of 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.
Key words: infected pancreatic necrosis, negative pressure method, NPWT, pancreatogenic sepsis, surgical treatment.
REFERENCES
- Savelyev VS, Filimonov MI, Burnevich SZ Pancreatic necrosis. — M .: OOO Medical Information Agency, 2008. — 264 p.
- Anisimov A.Yu., Andreev AI Prevention of vascular thrombosis of the portal system in patients with infected pancreatic necrosis. Kaz medical journal, 2011. — № 4. — S. 489 — 492.
- Schintler M.V. Negative pressure therapy: theory and practice. Diabetes Metab Res Rev 2012; 28: Suppl 1: 72-77.
- VN Obolensky, Ermolov AA, Hovhannisyan KS, Aronov LS Vacuum-assisted laparostomy in complex treatment of patients with peritonitis and internal biliary fistula. Surgery. Journal of them. NI Pirogov, 2013. — № 12. — S. 91 — 94. Obolenskiy V.N., Ermolov A.A., Oganesyan K.S., Aronov L.S. Vacuum-assisted laparostomy in complex treatment of patient with peritonitis and internal biliary fistula. Surgery. Log them. N.I. Pirogova, 2013. — No. 12. — S. 91 — 94.
- Taffurelli G., D’Ambra M., Buscemi S., Ricci C., Pezzilli R., Casadei R., Pigna A., Melotti R., Di Nino G., Minni F. Vacuum Assisted Closure Therapy in Severe Acute pancreatitis: Case Report and Literature Review. JOP. J Pancreas (Online) 2012 Sep 20; 13 (5 Suppl): 641.
- Khokonov MA, Stupin V., Abramov IS, Qahramanov TV, Khokonov AM Gornostaev NI Shevchenko MV The first experience of Vacuum — therapy in the treatment of infected pancreatic necrosis. — Topical issues of wounds and wound infections. The wound and wound infection, Materials of interregional scientific-practical conference with international participation, 30-31oktyabrya 2013, Kazan. — 142.
- Korymasov EA, Ivanov SA, Krichmar AM, Tsvetkov BY, Y. Gorbunov, Kozlov MN Bogdanov, VE, Fedorov DJ, Kukina YA The application of negative pressure in the surgical treatment of patients with severe acute pancreatitis. VI Annual interregional scientific-practical conference with international participation «Innovative technologies in the treatment of wounds and wound infections», 22-23 October 2015, St. Petersburg. Conference materials / Edited by AG Baindurashvili — SPb .: Alta Astra, 2015 — S. 160 — 162.
- Knaus W., Drapper E., Wagner D. APACHE II: A severity of disease classification system // Crit. Care Med. — 1985. — Vol. 13. — P. 818.
- Balthazar E.J. Acute pancreatitis: Assessment of severity with clinical and CT evaluation. Radiology 2002; 223: 603-613
- Bone R.C.The Systemic inflammatory response syndrome (SIRS). // In: Clinical trials for the treatment of sepsis, ed. by Sibbald W.J., Vincent J-L, 1995:. p. 4 — 12.