Internal vacuum-assisted closure device in the swine model of severe liver injury
<p>Abstract</p> <p>Objectives</p> <p>The authors present a novel approach to nonresectional therapy in major hepatic trauma utilizing intraabdominal perihepatic vacuum assisted closure (VAC) therapy in the porcine model of Grade V liver injury.</p> <p>Method...
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| Format: | Article |
| Language: | English |
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BMC
2012-12-01
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| Series: | World Journal of Emergency Surgery |
| Subjects: | |
| Online Access: | http://www.wjes.org/content/7/1/38 |
| _version_ | 1811311746627928064 |
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| author | Everett Christopher B Thomas Bruce W Moncure Michael |
| author_facet | Everett Christopher B Thomas Bruce W Moncure Michael |
| author_sort | Everett Christopher B |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Objectives</p> <p>The authors present a novel approach to nonresectional therapy in major hepatic trauma utilizing intraabdominal perihepatic vacuum assisted closure (VAC) therapy in the porcine model of Grade V liver injury.</p> <p>Methods</p> <p>A Grade V injury was created in the right lobe of the liver in a healthy pig. A Pringle maneuver was applied (4.5 minutes total clamp time) and a vacuum assisted closure device was placed over the injured lobe and connected to suction. The device consisted of a perforated plastic bag placed over the liver, followed by a 15 cm by 15cm VAC sponge covered with a nonperforated plastic bag. The abdomen was closed temporarily. Blood loss, cardiopulmonary parameters and bladder pressures were measured over a one-hour period. The device was then removed and the animal was euthanized.</p> <p>Results</p> <p>Feasibility of device placement was demonstrated by maintenance of adequate vacuum suction pressures and seal. VAC placement presented no major technical challenges. Successful control of ongoing liver hemorrhage was achieved with the VAC. Total blood loss was 625 ml (20ml/kg). This corresponds to class II hemorrhagic shock in humans and compares favorably to previously reported estimated blood losses with similar grade liver injuries in the swine model. No post-injury cardiopulmonary compromise or elevated abdominal compartment pressures were encountered, while hepatic parenchymal perfusion was maintained.</p> <p>Conclusion</p> <p>These data demonstrate the feasibility and utility of a perihepatic negative pressure device for the treatment of hemorrhage from severe liver injury in the porcine model.</p> |
| first_indexed | 2024-04-13T10:24:14Z |
| format | Article |
| id | doaj.art-bbe827b590444cd6bb50e9e488048030 |
| institution | Directory Open Access Journal |
| issn | 1749-7922 |
| language | English |
| last_indexed | 2024-04-13T10:24:14Z |
| publishDate | 2012-12-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Emergency Surgery |
| spelling | doaj.art-bbe827b590444cd6bb50e9e4880480302022-12-22T02:50:23ZengBMCWorld Journal of Emergency Surgery1749-79222012-12-01713810.1186/1749-7922-7-38Internal vacuum-assisted closure device in the swine model of severe liver injuryEverett Christopher BThomas Bruce WMoncure Michael<p>Abstract</p> <p>Objectives</p> <p>The authors present a novel approach to nonresectional therapy in major hepatic trauma utilizing intraabdominal perihepatic vacuum assisted closure (VAC) therapy in the porcine model of Grade V liver injury.</p> <p>Methods</p> <p>A Grade V injury was created in the right lobe of the liver in a healthy pig. A Pringle maneuver was applied (4.5 minutes total clamp time) and a vacuum assisted closure device was placed over the injured lobe and connected to suction. The device consisted of a perforated plastic bag placed over the liver, followed by a 15 cm by 15cm VAC sponge covered with a nonperforated plastic bag. The abdomen was closed temporarily. Blood loss, cardiopulmonary parameters and bladder pressures were measured over a one-hour period. The device was then removed and the animal was euthanized.</p> <p>Results</p> <p>Feasibility of device placement was demonstrated by maintenance of adequate vacuum suction pressures and seal. VAC placement presented no major technical challenges. Successful control of ongoing liver hemorrhage was achieved with the VAC. Total blood loss was 625 ml (20ml/kg). This corresponds to class II hemorrhagic shock in humans and compares favorably to previously reported estimated blood losses with similar grade liver injuries in the swine model. No post-injury cardiopulmonary compromise or elevated abdominal compartment pressures were encountered, while hepatic parenchymal perfusion was maintained.</p> <p>Conclusion</p> <p>These data demonstrate the feasibility and utility of a perihepatic negative pressure device for the treatment of hemorrhage from severe liver injury in the porcine model.</p>http://www.wjes.org/content/7/1/38Liver traumaNegative-pressure therapySwine modelHemorrhage |
| spellingShingle | Everett Christopher B Thomas Bruce W Moncure Michael Internal vacuum-assisted closure device in the swine model of severe liver injury World Journal of Emergency Surgery Liver trauma Negative-pressure therapy Swine model Hemorrhage |
| title | Internal vacuum-assisted closure device in the swine model of severe liver injury |
| title_full | Internal vacuum-assisted closure device in the swine model of severe liver injury |
| title_fullStr | Internal vacuum-assisted closure device in the swine model of severe liver injury |
| title_full_unstemmed | Internal vacuum-assisted closure device in the swine model of severe liver injury |
| title_short | Internal vacuum-assisted closure device in the swine model of severe liver injury |
| title_sort | internal vacuum assisted closure device in the swine model of severe liver injury |
| topic | Liver trauma Negative-pressure therapy Swine model Hemorrhage |
| url | http://www.wjes.org/content/7/1/38 |
| work_keys_str_mv | AT everettchristopherb internalvacuumassistedclosuredeviceintheswinemodelofsevereliverinjury AT thomasbrucew internalvacuumassistedclosuredeviceintheswinemodelofsevereliverinjury AT moncuremichael internalvacuumassistedclosuredeviceintheswinemodelofsevereliverinjury |