Spillebeen Anneleen L, Robben Joris H, Thomas Rachel, Kirpensteijn Jolle, van Nimwegen Sebastiaan A
Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, the Netherlands.
Department of Veterinary Pathology, Faculty of Veterinary Medicine, Utrecht University, the Netherlands.
Vet Surg. 2017 Nov;46(8):1086-1097. doi: 10.1111/vsu.12703. Epub 2017 Sep 1.
To compare passive open abdominal drainage (POAD) and negative-pressure abdominal drainage (NPAD) using the ABThera™ system in the treatment of septic peritonitis.
Randomized prospective clinical trial.
Dogs (n = 16) with septic peritonitis.
Dogs with septic peritonitis were randomly assigned to one of two treatment protocols: NPAD versus POAD. Anesthesia time, operating time, duration of drainage, costs, survival, and complications were compared between techniques. Hematological and biochemical parameters in blood and abdominal fluid, and histopathological findings of omentum and abdominal wall tissue samples were compared between NPAD and POAD at time of initial surgery and at time of closure.
Overall survival was 81%. Treatment costs, anesthesia and operating time, drainage time, survival, and postoperative complications were similar between techniques. Loss of total plasma protein and decreased inflammation-related factors in abdominal fluid at time of closure were noted in all patients. Neutrophilic inflammation was greater in abdominal wall samples after NPAD. POAD patients showed discomfort during bandage changes and had frequent leakage of abdominal fluid outside of the bandage.
NPAD is an effective alternative to POAD for treatment of septic peritonitis, based on costs and survival. NPAD resulted in less abdominal fluid leakage, and evidence of superior healing on histological evaluation of abdominal tissues.
比较使用ABThera™系统的被动开放式腹腔引流(POAD)和负压腹腔引流(NPAD)在治疗化脓性腹膜炎中的效果。
随机前瞻性临床试验。
患有化脓性腹膜炎的犬(n = 16)。
将患有化脓性腹膜炎的犬随机分配至两种治疗方案之一:NPAD与POAD。比较两种技术的麻醉时间、手术时间、引流持续时间、成本、生存率和并发症。在初次手术时和缝合时,比较NPAD和POAD之间血液和腹腔液中的血液学和生化参数,以及大网膜和腹壁组织样本的组织病理学结果。
总体生存率为81%。两种技术的治疗成本、麻醉和手术时间、引流时间、生存率和术后并发症相似。所有患者在缝合时均出现血浆总蛋白丢失和腹腔液中炎症相关因子减少。NPAD后腹壁样本中的中性粒细胞炎症更严重。POAD患者在更换绷带时感到不适,且绷带外腹腔液频繁渗漏。
基于成本和生存率,NPAD是治疗化脓性腹膜炎的一种有效的POAD替代方案。NPAD导致腹腔液渗漏较少,并且在腹部组织的组织学评估中有更好的愈合证据。