Hypochlorous Acid for Septic Abdominal Processes Using a Unique Negative Pressure Wound Therapy System:A Pilot Study  

作　　者：Marc R.Matthews Asia N.Quan Anushi R.Shah Carmen I.Tugulan Beshoy A.Nashed Ross F.Goldberg Paola G.Pieri Luis G.Fernandez Areta Kowal-Vern Kevin N.Foster 

机构地区：[1]The Arizona Burn Center,Department of Surgery,Maricopa Integrated Health Systems,Phoenix,AZ,USA [2]Burn/Trauma Critical Care,Department of Inpatient Pharmacy,Maricopa Integrated Health Systems,Phoenix,AZ,USA [3]Department of Surgery,Maricopa Integrated Health Systems,Phoenix,AZ,USA [4]Department of Surgery,Mountain Vista Medical Center,Phoenix,AZ,USA [5]Division of Trauma Surgery/Surgical Critical Care,Trauma Surgical Critical Care Unit,Christus Trinity Mother Frances Health System,Tyler,TX,USA [6]Department of Research,The Arizona Burn Center,Maricopa Integrated Health Systems,Phoenix,AZ,USA

出　　处：《Surgical Science》2018年第11期412-421,共10页外科学（英文）

摘　　要：Background: Septic open abdomens occur in trauma, burn and surgery. Currently, multiple concentrations of hypochlorous acid solutions have effectively decreased the microbiotic burden in wounds. We 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. Methods: This is a retrospective observational review of patients who required delayed abdominal closures after exploratory laparotomies. 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. Results: 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. Conclusion: There were no episodes of electrolyte imbalance, hypotension, hypertension, anaphylaxis, hemorrhage, visceral injury or systemic toxicity. V-HOCL with/without NPWT-i irrigation was a safe modality and tolerated well in this study.Background: Septic open abdomens occur in trauma, burn and surgery. Currently, multiple concentrations of hypochlorous acid solutions have effectively decreased the microbiotic burden in wounds. We 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. Methods: This is a retrospective observational review of patients who required delayed abdominal closures after exploratory laparotomies. 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. Results: 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. Conclusion: There were no episodes of electrolyte imbalance, hypotension, hypertension, anaphylaxis, hemorrhage, visceral injury or systemic toxicity. V-HOCL with/without NPWT-i irrigation was a safe modality and tolerated well in this study.

关 键 词：Abthera^(TM) Hypochlorous Acid Negative Pressure Wound Therapy-Irrigation(NPWT-i) Septic Abdomen Temporary Abdominal Closure(TAC) V.A.C.VeraFlo^(TM) Vashe^(█) 

分 类 号：R73[医药卫生—肿瘤]