Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jan 18:4:2050312115624988.
doi: 10.1177/2050312115624988. eCollection 2016.

In vitro pressure manifolding distribution evaluation of ABThera(™) Active Abdominal Therapy System, V.A.C.(®) Abdominal Dressing System, and Barker's vacuum packing technique conducted under dynamic conditions

Angel Delgado  1 , Alexander Sammons  2
Affiliations

In vitro pressure manifolding distribution evaluation of ABThera(™) Active Abdominal Therapy System, V.A.C.(®) Abdominal Dressing System, and Barker's vacuum packing technique conducted under dynamic conditions

Angel Delgado et al. SAGE Open Med. .

Abstract

Objectives: Temporary abdominal closure methods allow for management of open abdomens where immediate primary closure is not possible and/or where repeat abdominal entries are necessary. We assessed pressure mapping and fluid extraction efficiency of three open abdomen dressing systems: ABThera(™) Active Abdominal Therapy System, V.A.C.(®) Abdominal Dressing System, and Barker's vacuum packing technique.

Methods: An in vitro test model was designed to simulate physical conditions present in an open abdomen. The model consisted of a rigid rest platform with elevated central region and a flexible outer layer with centrally located incision. Constant -125 mmHg negative pressure was applied according to the type of system, under simulated dynamic conditions, using albumin-based solution with a viscosity of 14 cP. Data were collected by pressure sensors located circumferentially into three concentric zones: Zone 1 (closest to negative pressure source), Zone 2 (immediately outside of manifolding material edge), and Zone 3 (area most distal from negative pressure source). Each value was the result of approximately 100 pressure readings/zone/experiment with a total of three experiments for each system.

Results: Pressure distribution of ABThera Therapy was significantly (p < 0.05) superior to Barker's vacuum packing technique in all three evaluated zones. Similarly, V.A.C. Abdominal Dressing System pressure distribution was significantly (p < 0.05) improved compared to Barker's vacuum packing technique in all zones. There were no pressure distribution differences in Zone 1 between ABThera Therapy and V.A.C. Abdominal Dressing System; however, in Zones 2 and 3, ABThera Therapy was significantly (p < 0.05) superior to V.A.C. Abdominal Dressing System.

Conclusions: These data suggest that all approaches to negative pressure therapy for open abdomen treatment are not equal. Additional research should be conducted to elucidate clinical implications of data demonstrated here.

Keywords: Negative pressure therapy; open abdomen; pressure mapping; temporary abdominal closure.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr Delgado is an employee of Acelity (San Antonio, TX).

Figures

Figure 1.
Figure 1.
Model consisted of a rigid rest platform having an elevated central region and a flexible outer layer with a centrally located incision. The dressing was placed between the rigid and flexible layers and was sealed around the perimeter.
Figure 2.
Figure 2.
Depiction of all three TAC techniques on the bench testing model: (a) VADS, (b) ABThera™ Therapy, and (c) BVPT.
Figure 3.
Figure 3.
Depiction of all three TAC techniques’ data collection topology: (a) VADS, (b) ABThera™ Therapy, and (c) BVPT.
Figure 4.
Figure 4.
Graphical representation of volume extraction for TACs in triplicates.
Figure 5.
Figure 5.
Graphical representation of volume extraction rates for all TACs.
Figure 6.
Figure 6.
Electron micrographs of (a) cotton-based towels and (b) open cell foam demonstrating void space for fluid movement.
See this image and copyright information in PMC

References

    1. MacLean AA, O’Keeffe T, Augenstein J. Management strategies for the open abdomen: survey of the American Association for the Surgery of Trauma membership. Acta Chir Belg 2008; 108(2): 212–218. - PubMed
    1. Kaplan M. Managing the open abdomen. Ostomy Wound Manage 2004; 50(Suppl. 1A): C2–C8. - PubMed
    1. Kaplan M, Banwell P, Orgill DP, et al. Guidelines for the management of the open abdomen. Wounds 2005; 17(Suppl. 1): S1–S24.
    1. Hess DR, Bigatello LM. The chest wall in acute lung injury/acute respiratory distress syndrome. Curr Opin Crit Care 2008; 14(1): 94–102. - PubMed
    1. Moore FA, Sauaia A, Moore EE, et al. Postinjury multiple organ failure: a bimodal phenomenon. J Trauma 1996; 40(4): 501–510. - PubMed

LinkOut - more resources