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Chin J Traumatol. 2019 Feb;22(1):1-11. doi: 10.1016/j.cjtee.2018.10.005. Epub 2019 Feb 14.

Chinese Trauma Surgeon Association for management guidelines of vacuum sealing drainage application in abdominal surgeries-Update and systematic review.

Author information

1
Trauma Center of PLA, State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China.
2
Trauma Center/Department of Emergency and Trauma Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.
3
Trauma Center of PLA, State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China. Electronic address: dpzhangly@163.com.
4
Trauma Center/Department of Emergency and Trauma Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China. Electronic address: baixiangjun@hotmail.com.
5
Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangzhou Province, China.
6
Fujian Provincial Hospital, Fuzhou, China.
7
Emergency Surgery of the First Affiliated Hospital, Shihezi University School of Medicine, Shihezi, Xinjiang Autonomous Region, China.
8
The First Affiliated Hospital of Hainan Medical University, Haikou, China.
9
Chongqing Emergency Medical Center, Chongqing, China.
10
Taizhou Hospital of Zhejiang Province, Taizhou, Zhejiang Province, China.
11
Yuyao People's Hospital of Zhejiang Province, Yuyao, Zhejiang Province, China.
12
Ninth People's Hospital of Zhengzhou, Zhengzhou, China.
13
Zhongnan Hospital of Wuhan University, Wuhan, China.
14
Chengdu Military General Hospital, Chengdu, China.
15
Tiantai County People's Hospital, Tiantai, Zhejiang, China.
16
The First Affiliated Hospital of Nanchang University, Nanchang, China.
17
Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
18
Department of Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
19
Shenyang Military General Hospital, Shenyang, China.
20
The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
21
The Affiliated Hospital of Guizhou Medical University, Guiyang, China.
22
The First People's Hospital of Kunming, Kunming, China.
23
Qilu Hospital of Shandong University, Jinan, China.
24
The First Affiliated Hospital of Third Military Medical University, Chongqing, China.

Abstract

Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chinese Trauma Surgeon Association organized a committee composed of 28 experts across China in July 2017, aiming to provide an evidence-based recommendation for the application of VSD in abdominal surgeries. Eleven questions regarding the use of VSD in abdominal surgeries were addressed: (1) which type of materials should be respectively chosen for the intraperitoneal cavity, retroperitoneal cavity and superficial incisions? (2) Can VSD be preventively used for a high-risk abdominal incision with primary suture? (3) Can VSD be used in severely contaminated/infected abdominal surgical sites? (4) Can VSD be used for temporary abdominal cavity closure under some special conditions such as severe abdominal trauma, infection, liver transplantation and intra-abdominal volume increment in abdominal compartment syndrome? (5) Can VSD be used in abdominal organ inflammation, injury, or postoperative drainage? (6) Can VSD be used in the treatment of intestinal fistula and pancreatic fistula? (7) Can VSD be used in the treatment of intra-abdominal and extra-peritoneal abscess? (8) Can VSD be used in the treatment of abdominal wall wounds, wound cavity, and defects? (9) Does VSD increase the risk of bleeding? (10) Does VSD increase the risk of intestinal wall injury? (11) Does VSD increase the risk of peritoneal adhesion? Focusing on these questions, evidence-based recommendations were given accordingly. VSD was strongly recommended regarding the questions 2-4. Weak recommendations were made regarding questions 1 and 5-11. Proper use of VSD in abdominal surgeries can lower the risk of infection in abdominal incisions with primary suture, treat severely contaminated/infected surgical sites and facilitate temporary abdominal cavity closure.

KEYWORDS:

Abdominal surgery; Guideline; Vacuum sealing drainage

PMID:
30850324
PMCID:
PMC6529401
DOI:
10.1016/j.cjtee.2018.10.005
[Indexed for MEDLINE]
Free PMC Article

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