All critical care units in the UK are being encouraged to review how they look after patients whose abdomens are left open after surgery or injury.
This comes after a specialist unit raised concerns to the National Institute for Health and Clinical Excellence (NICE) that there may be a link between one of the treatments currently used, called Negative Pressure Wound Therapy (NPWT), and patients developing intestinal fistulae, a potentially serious condition which can cause infection and bowel leaking. NPWT is used to treat patients with open abdomens (laparostomies) where the intestine and other internal organs are exposed; for example when there is severe infection or to allow further treatment inside the abdomen. It involves specifically-trained clinical staff applying a vacuum system to the open abdominal wound and surrounding area, which removes fluid and infected material, thereby reducing the chance of further infection and allowing the wound to heal sooner. Patients with laparostomies are already at risk of developing intestinal fistulae due to their clinical condition and there is currently no published evidence that NWPT causes this. Therefore, in order to determine whether there is an increased risk, NICE has asked all intensive care and high dependency units in the UK to submit information on all patients who have laparostomies between 1 January 2010 and 30 June 2011. The University of Aberdeen will provide NICE with an independent analysis of the data received.
