Hypochlorous Acid for Septic Abdominal Processes Using a Unique Negative Pressure Wound Therapy System
Open abdomen is an abdominal wall defect
created by intentionally leaving an abdominal incision open at the completion
of intra-abdominal surgery or by opening (or reopening) the abdomen. Open abdomen can also be the result of injuries to the abdominal wall
that produce significant soft tissue defects. Currently, multiple
concentrations of hypochlorous (HOCL) acid solutions have effectively decreased
the microbiotic burden in wounds.
In this paper, the
authors hypothesized that Vashe®, a neutral hypochlorous acid
solution (V-HOCL), would be safe as an intraperitoneal irrigation or washout
disinfectant for septic open abdomens utilizing negative pressure wound
therapy. They conducted a retrospective observational pilot study (January
2017-January 2018) to determine the feasibility of utilizing V-HOCL as a
washout or irrigant for septic open abdomen. Hypochlorous
acid was used in surgical patients with either open abdomens who required
abdominal washouts during surgery or who required more intensive irrigation
treatment with negative pressure wound therapy for a longer term. Group A (n = 8)
had cyclical V-HOCL irrigation to their open abdomens combining AbtheraTM and
V.A.C. Dressing System for negative pressure wound therapy with irrigation
(NPWT-i) and Group B (n = 9) had intra-abdominal V-HOCL washouts.
The results showed
that fifty percent of both groups had either septic or hemorrhagic shock on
admission. Compared to Group B, Group A patients were older (median 50 vs 37
years), and had a median hospitalization of 28 vs 8 days, 4 times as many
operations, more acute renal failure and co-morbidities. No statistically
significant differences were detected be-tween the two treatment methods with
the V-HOCL delivery and removal.
In conclusion, this
pilot study has shown that Vashe®, a 0.033% hypochlorous acid in
normal saline solution is safe as a standard surgical intra-abdominal washout
or NPWT-i irrigant using the combination of the AbtheraTM device and
V.A.C. Dressing SystemTM for septic open abdomens. In patients
requiring an exploratory laparotomy and possibly an open abdomen for continuous
irrigation or a single washout of the abdomen, these interventions may provide
a benefit to the patient with a septic open abdomen.
Article by Marc R. Matthews, et al, from
USA.
Full access: http://mrw.so/4FE5iM
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