Severe Acute Pancreatitis Treated with Negative Pressure Wound Therapy System: Influence of Laboratory Markers

Author:

Ciuntu Bogdan Mihnea1,Vintilă Dan1,Tanevski Adelina1,Chiriac Ștefan2,Stefănescu Gabriela2ORCID,Abdulan Irina Mihaela3,Balan Gheorghe G.2,Veliceasa Bogdan4ORCID,Bădulescu Oana Viola5,Ghiga Gabriela6,Fătu Ana Maria7,Georgescu Andrei8,Vascu Mihai Bogdan8,Vasilescu Alin Mihai1ORCID

Affiliation:

1. Department of General Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania

2. Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania

3. Department of Medical Specialties I, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania

4. Department of Traumatology and Orthopaedics, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania

5. Department of Haematholohy, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania

6. Department of Mother and Child Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania

7. Discipline of Ergonomy, Department of Implantology Removable Denture Technology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania

8. Department of Odontology, Periodontology and Fixed Prosthesis, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania

Abstract

(1) Background: An open abdomen is a serious medical condition that requires prompt and effective treatment to prevent complications and improve patient outcomes. Negative pressure therapy (NPT) has emerged as a viable therapeutic option for temporary closure of the abdomen, offering several benefits over traditional methods. (2) Methods: We included 15 patients with pancreatitis who were hospitalized in the I–II Surgery Clinic of the Emergency County Hospital “St. Spiridon” from Iasi, Romania, between 2011–2018 and received NPT. (3) Results: Preoperatively, the mean IAP level was 28.62 mmHg, decreasing significantly postoperatively to 21.31 mmHg. The mean level of the highest IAP value recorded in pancreatitis patients treated with VAC did not differ significantly by lethality (30.31 vs. 28.50; p = 0.810). In vacuum-treated pancreatitis patients with a IAP level > 12, the probability of survival dropped below 50% during the first 7 days of stay in the ICU, so that after 20 days the probability of survival was approximately 20%. IAP enters the determinism of surgery with a sensitivity of 92.3% and a specificity of 99%, the cut-off value of IAP being 15 mmHg. (4) Conclusions: The timing of surgical decompression in abdominal compartment syndrome is very important. Consequently, it is vital to identify a parameter, easy to measure, within the reach of any clinician, so that the indication for surgical intervention can be made judiciously and without delay.

Publisher

MDPI AG

Subject

General Medicine

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