Vacuum-assisted closure device in intensive care unit patients and dissemination of Gram-negative bacteria 英文参考文献.docVIP

Papanikolaou et al. Critical Care 2010, 14:413 /content/14/2/413 LET TER Vacuum-assisted closure device in intensive care unit patients and dissemination of Gram-negative bacteria Metaxia N Papanikolaou , Margarita Balla , Panagiotis G Drimousis* , Anna Xanthaki , Athanasia Tsirigga 1 1 1 2 2 and Aikaterini A Charalambous 1 See related research by Batacchi et al., /content/13/6/R194 We read with interest the study by Batacchi and colleagues in a recent issue of Critical Care [1]. Vacuum- assisted closure (VAC) decompression is promising for the management of open abdomen, but our limited experience with this system suggests that dissemination of bacteria may occur. Recently, two patients were treated with VAC in our intensive care unit (ICU). Patient 1 was a 62-year-old man who was originally operated on for paraganglioma and underwent left nephrectomy and gastrojejunal anastomosis. Patient 2 was a 54-year-old woman who was admitted to the ICU two months after a complicated laparoscopic sleeve gastrectomy for morbid obesity. In both patients, at a certain point during their course, intra-abdominal sepsis developed, and they were both managed with extensive debridement, drainage, and VAC placement. Both patients developed ? stulas, and although dressings and VAC pump containers were meticulously changed, leaks were repeatedly observed around the dressings. Figure 1. Number of positive Gram-negative and Gram-positive cultures in our intensive care unit during the stay of patients 1 (left) and 2 (right). The arrows represent the time of vacuum- assisted closure placement for each patient. Furthermore, 2 to 4 weeks after th