Application of vacuum-instillation laparostomy in gunshot abdominal wounds
https://doi.org/10.24884/0042-4625-2023-182-6-50-54
Abstract
Penetrating abdominal wounds occupy a significant place in the structure of gunshot injuries in peacetime and war. They are usually characterized by extensive multiorgan damage with the development of peritonitis, the course of which largely determines the outcome of treatment. Therefore, the main task in providing specialized surgical care for victims with gunshot abdominal wounds is to relieve peritonitis in order to prevent the generalization of the septic process. One of the modern trends in solving this problem is vacuum-assisted laparostomy. However, data on its use are presented in rare publications and are usually based on small samples of patients with secondary peritonitis. At the same time, we did not find any information in the available sources about the effectiveness of the most promising modification of this technique – vacuum-instillation laparostomy for gunshot abdominal wounds. This article demonstrates the first experience of the successful use of vacuum-instillation laparostomy in a patient with gunshot abdominal wound complicated by abdominal sepsis. The obtained results indicate the high potential of using this technique in this difficult category of patients.
About the Authors
P. N. RomashchenkoRussian Federation
Romashchenko Pavel N., Dr. of Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences, Head of the Department and Clinic of Faculty Surgery named after S. P. Fedorov
A. A. Sazonov
Russian Federation
Sazonov Alexey A., Dr. of Sci. (Med.), Deputy Head of the Department and Clinic of Faculty Surgery named after S. P. Fedorov
6, Academika Lebedeva str., Saint Petersburg, 194044
N. A. Maistrenko
Russian Federation
Maistrenko Nikolay A., Dr. of Sci. (Med.), Professor, Academician of the Russian Academy of Sciences, Professor of the Department and Clinic of Faculty Surgery named after S. P. Fedorov
Saint Petersburg
I. A. Makarov
Russian Federation
Makarov Ivan A., Associate Professor of the Department of Faculty Surgery named after S. P. Fedorova
Saint Petersburg
R. K. Aliev
Russian Federation
Aliev Rustam K., Associate Professor of the Department of Faculty Surgery named after S. P. Fedorova
Saint Petersburg
V. V. Semenov
Russian Federation
Semenov Valeriy V., Cand. of Sci. (Med.), Lieutenant Colonel of the Medical Service, Senior Lecturer of the Department of Faculty Surgery named after S. P. Fedorov
Saint Petersburg
D. S. Krivolapov
Russian Federation
Krivolapov Denis S., Cand. of Sci. (Med.), Lecturer of the Department of Faculty Surgery named after S. P. Fedorov
Saint Petersburg
References
1. Alisov PG, Samokhvalov IM. Gunshot wounds to the abdomen. Features, diagnosis and treatment in modern conditions. St. Petersburg: Synthesis Book, 2018. 320 p. (In Russ.).
2. Livingston DH, Lavery RF, Lopreiato MC. et al. Unrelenting violence: an analysis of 6,322 gunshot wound patients at a Level I trauma center J. Trauma Acute Care Surg. 2014;76(1):2–9.
3. Jeffery S. The Management of Combat Wounds: The British Military Experience. // Adv. Wound Care. 2016. Vol. 5, No. 10. P. 464–473.
4. Ge D. The safety of negative-pressure wound therapy on surgical wounds: an updated meta-analysis of 17 randomized controlled trials. Adv. Skin Wound Care. 2018; 31(9): 421–428.
5. Coccolini F, Montori G, Ceresoli M. et al. IROA: International Register of Open Abdomen, preliminary results. World J Emerg Surg. 2017; 12:1-10.
6. Fernandez LG, Sibaja AP, Kaplan MJ. et al. Application of Negative Pressure Wound Therapy with Instillation and Dwell Time of the Open Abdomen: Initial Experience. // Cureus. 2019; 11(9):5667. DOI: 10.7759/cureus.5667
7. Cherdantsev DV, Pervova OV, Trofimovich YuG. et al. Possibility of increasing the effectiveness of perioperative sanitation of the abdominal cavity in case of peritonitis. Siberian Medical Review. 2018;1:20-26. DOI: 10.20333/2500136-2018-1-20-26. (In Russ.).
Supplementary files
Review
For citations:
Romashchenko P.N., Sazonov A.A., Maistrenko N.A., Makarov I.A., Aliev R.K., Semenov V.V., Krivolapov D.S. Application of vacuum-instillation laparostomy in gunshot abdominal wounds. Grekov's Bulletin of Surgery. 2023;182(6):50-54. (In Russ.) https://doi.org/10.24884/0042-4625-2023-182-6-50-54