INSTILLATION NEGATIVE PRESSURE WOUND THERAPY (NPWTi) FOR OPEN ABDOMEN (OA) MANAGEMENT IN COMPLICATED INTRA-ABDOMINAL INFECTIONS (CIAI): A LITERATURE R

Authors:
Karina Tarayona

Body of Abstract:
ABSTRACT
Introduction: Complicated Intra-Abdominal Infection (cIAI) is a widespread intra-abdominal organ infection that is a serious problem associated with high morbidity and mortality for patients. Most cIAI cases require management of Open Abdomen (OA) with abdominal sepsis as the main indication. Negative Pressure Wound Therapy (NPWT) can be applied to OA to remove exudate, reduce edema, increase the speed of wound healing, form tissue granulation, as well as modern dressings, especially in the case of cIAI. However, conventional NPWT is contraindicated for infected and contaminated wounds so it is necessary to use a more innovative method, instillation NPWT (NPWTi), to treat cases with complex contaminated wounds.
Objective: This literature review aims to assess the effectiveness of applying NPWTi in the management of OA procedures to treat cIAI conditions.
Methods: Literature retrieval included searches in five main databases, namely Scopus, PubMed, ProQuest, Sciencedirect, and Google Scholar, based on publications from 2013 – 2023. Searches were carried out using keywords (“instillation” AND “NPWT” AND “open abdomen”AND”management” AND (“complicated” OR “intra-abdominal” OR “infections”)). PRISMA was used to select articles to ensure a comprehensive literature review. The quality of each article is critically assessed using Newcastle-Ottawa Scale (NOS) for cohort and JBI critical appraisal tools for case report and case series studies.
Results: Literature searches in Scopus (6 studies), Pubmed (10 studies), Proquest (26 studies), Science Direct (31 studies), and Google Scholar (235 studies) identified 5 studies (with total of 230 cases) demonstrating the effectiveness of NPWTi in OA for managing cIAI.
Conclusion: Conventional NPWT as cIAI adjuvant therapy with OA is effective in promoting wound healing and increasing granulation tissue. However, OA management with NPWTi actually shows more effective management of cIAI, higher wound healing rates, faster fascial closure, and lower mortality rates. lower. NPWT with an instillation system is an efficient and safe alternative choice for treating cIAI cases with OA.
Keywords: Instillation Negative Pressure Wound Therapy (NPWTi); Open Abdomen (OA); complicated Intra-Abdominal Infections (cIAI)