Effect of intestinal pressure on fistula closure during vacuum assisted treatment: A computational approach

Autores
Cattoni, Diego I.; Ravazzola, Constanza; Tüngler, Victoria; Wainstein, Daniel E.; Chara, Osvaldo
Año de publicación
2011
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background: Enterocutaneous fistulae, pathological communications between the intestinal lumen and the abdominal skin, can arise as serious complication of gastrointestinal surgery. A current non-surgical treatment for this pathology involves topical application of sub-atmospheric pressure, also known as vacuum assisted closure (VAC). While this technique appears to be promising, surgeons report a number of cases in which its application fails to achieve fistula closure. Here, we evaluate the fistula's physical properties during the vacuum assisted closure process in a computational approach exploring the relevance of intraluminal intestinal pressure. Methods: A mathematical model formulated by differential equations based on tissue elasticity properties and principles of fluid mechanics was created and forcing functions were integrated to mimic intestinal pressure dynamics. A software to solve equations and to fit the model to experimentally obtained data was developed. This enabled simulations of vacuum assisted fistula closure under different intestinal pressure. Results: The simulation output indicates conditions, in which fistula closure can or cannot be expected suggesting favoured or impeded healing, respectively. When modifications of intestinal pressure, as observed in fistula accompanying pathologies, are integrated, the outcome of fistula closure changes considerably. Rise of intestinal pressure is associated with delay of fistula closure and temporary fistula radius augmentation, while reduction of intestinal pressure during sub-atmospheric pressure treatment contributes to a faster and direct fistula closure. Conclusion: From the model predictions, we conclude that administration of intestinal pressure decreasing compounds (e.g. butylscopolamine, glucagon) may improve VAC treatment, while intestinal pressure increasing drugs should be avoided.
Facultad de Ciencias Exactas
Instituto de Física de Líquidos y Sistemas Biológicos
Materia
Ciencias Exactas
Ciencias Médicas
Computational model
Enterocutaneous fistula
Fistula radius
Intestinal pressure
Simulation
Nivel de accesibilidad
acceso abierto
Condiciones de uso
http://creativecommons.org/licenses/by-nc-sa/4.0/
Repositorio
SEDICI (UNLP)
Institución
Universidad Nacional de La Plata
OAI Identificador
oai:sedici.unlp.edu.ar:10915/84083

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oai_identifier_str oai:sedici.unlp.edu.ar:10915/84083
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repository_id_str 1329
network_name_str SEDICI (UNLP)
spelling Effect of intestinal pressure on fistula closure during vacuum assisted treatment: A computational approachCattoni, Diego I.Ravazzola, ConstanzaTüngler, VictoriaWainstein, Daniel E.Chara, OsvaldoCiencias ExactasCiencias MédicasComputational modelEnterocutaneous fistulaFistula radiusIntestinal pressureSimulationBackground: Enterocutaneous fistulae, pathological communications between the intestinal lumen and the abdominal skin, can arise as serious complication of gastrointestinal surgery. A current non-surgical treatment for this pathology involves topical application of sub-atmospheric pressure, also known as vacuum assisted closure (VAC). While this technique appears to be promising, surgeons report a number of cases in which its application fails to achieve fistula closure. Here, we evaluate the fistula's physical properties during the vacuum assisted closure process in a computational approach exploring the relevance of intraluminal intestinal pressure. Methods: A mathematical model formulated by differential equations based on tissue elasticity properties and principles of fluid mechanics was created and forcing functions were integrated to mimic intestinal pressure dynamics. A software to solve equations and to fit the model to experimentally obtained data was developed. This enabled simulations of vacuum assisted fistula closure under different intestinal pressure. Results: The simulation output indicates conditions, in which fistula closure can or cannot be expected suggesting favoured or impeded healing, respectively. When modifications of intestinal pressure, as observed in fistula accompanying pathologies, are integrated, the outcome of fistula closure changes considerably. Rise of intestinal pressure is associated with delay of fistula closure and temporary fistula radius augmentation, while reduction of intestinal pressure during sub-atmospheric pressure treatment contributes to a faster and direct fistula closure. Conclusion: From the model predictions, we conclude that administration of intestinal pressure decreasing compounds (e.g. butylscopolamine, glucagon) may improve VAC treatment, while intestinal pressure increasing drugs should be avoided.Facultad de Ciencias ExactasInstituto de Física de Líquidos y Sistemas Biológicos2011info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionArticulohttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdf662-668http://sedici.unlp.edu.ar/handle/10915/84083enginfo:eu-repo/semantics/altIdentifier/issn/1743-9191info:eu-repo/semantics/altIdentifier/doi/10.1016/j.ijsu.2011.09.001info:eu-repo/semantics/openAccesshttp://creativecommons.org/licenses/by-nc-sa/4.0/Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0)reponame:SEDICI (UNLP)instname:Universidad Nacional de La Platainstacron:UNLP2025-10-22T16:56:56Zoai:sedici.unlp.edu.ar:10915/84083Institucionalhttp://sedici.unlp.edu.ar/Universidad públicaNo correspondehttp://sedici.unlp.edu.ar/oai/snrdalira@sedici.unlp.edu.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:13292025-10-22 16:56:57.224SEDICI (UNLP) - Universidad Nacional de La Platafalse
dc.title.none.fl_str_mv Effect of intestinal pressure on fistula closure during vacuum assisted treatment: A computational approach
title Effect of intestinal pressure on fistula closure during vacuum assisted treatment: A computational approach
spellingShingle Effect of intestinal pressure on fistula closure during vacuum assisted treatment: A computational approach
Cattoni, Diego I.
Ciencias Exactas
Ciencias Médicas
Computational model
Enterocutaneous fistula
Fistula radius
Intestinal pressure
Simulation
title_short Effect of intestinal pressure on fistula closure during vacuum assisted treatment: A computational approach
title_full Effect of intestinal pressure on fistula closure during vacuum assisted treatment: A computational approach
title_fullStr Effect of intestinal pressure on fistula closure during vacuum assisted treatment: A computational approach
title_full_unstemmed Effect of intestinal pressure on fistula closure during vacuum assisted treatment: A computational approach
title_sort Effect of intestinal pressure on fistula closure during vacuum assisted treatment: A computational approach
dc.creator.none.fl_str_mv Cattoni, Diego I.
Ravazzola, Constanza
Tüngler, Victoria
Wainstein, Daniel E.
Chara, Osvaldo
author Cattoni, Diego I.
author_facet Cattoni, Diego I.
Ravazzola, Constanza
Tüngler, Victoria
Wainstein, Daniel E.
Chara, Osvaldo
author_role author
author2 Ravazzola, Constanza
Tüngler, Victoria
Wainstein, Daniel E.
Chara, Osvaldo
author2_role author
author
author
author
dc.subject.none.fl_str_mv Ciencias Exactas
Ciencias Médicas
Computational model
Enterocutaneous fistula
Fistula radius
Intestinal pressure
Simulation
topic Ciencias Exactas
Ciencias Médicas
Computational model
Enterocutaneous fistula
Fistula radius
Intestinal pressure
Simulation
dc.description.none.fl_txt_mv Background: Enterocutaneous fistulae, pathological communications between the intestinal lumen and the abdominal skin, can arise as serious complication of gastrointestinal surgery. A current non-surgical treatment for this pathology involves topical application of sub-atmospheric pressure, also known as vacuum assisted closure (VAC). While this technique appears to be promising, surgeons report a number of cases in which its application fails to achieve fistula closure. Here, we evaluate the fistula's physical properties during the vacuum assisted closure process in a computational approach exploring the relevance of intraluminal intestinal pressure. Methods: A mathematical model formulated by differential equations based on tissue elasticity properties and principles of fluid mechanics was created and forcing functions were integrated to mimic intestinal pressure dynamics. A software to solve equations and to fit the model to experimentally obtained data was developed. This enabled simulations of vacuum assisted fistula closure under different intestinal pressure. Results: The simulation output indicates conditions, in which fistula closure can or cannot be expected suggesting favoured or impeded healing, respectively. When modifications of intestinal pressure, as observed in fistula accompanying pathologies, are integrated, the outcome of fistula closure changes considerably. Rise of intestinal pressure is associated with delay of fistula closure and temporary fistula radius augmentation, while reduction of intestinal pressure during sub-atmospheric pressure treatment contributes to a faster and direct fistula closure. Conclusion: From the model predictions, we conclude that administration of intestinal pressure decreasing compounds (e.g. butylscopolamine, glucagon) may improve VAC treatment, while intestinal pressure increasing drugs should be avoided.
Facultad de Ciencias Exactas
Instituto de Física de Líquidos y Sistemas Biológicos
description Background: Enterocutaneous fistulae, pathological communications between the intestinal lumen and the abdominal skin, can arise as serious complication of gastrointestinal surgery. A current non-surgical treatment for this pathology involves topical application of sub-atmospheric pressure, also known as vacuum assisted closure (VAC). While this technique appears to be promising, surgeons report a number of cases in which its application fails to achieve fistula closure. Here, we evaluate the fistula's physical properties during the vacuum assisted closure process in a computational approach exploring the relevance of intraluminal intestinal pressure. Methods: A mathematical model formulated by differential equations based on tissue elasticity properties and principles of fluid mechanics was created and forcing functions were integrated to mimic intestinal pressure dynamics. A software to solve equations and to fit the model to experimentally obtained data was developed. This enabled simulations of vacuum assisted fistula closure under different intestinal pressure. Results: The simulation output indicates conditions, in which fistula closure can or cannot be expected suggesting favoured or impeded healing, respectively. When modifications of intestinal pressure, as observed in fistula accompanying pathologies, are integrated, the outcome of fistula closure changes considerably. Rise of intestinal pressure is associated with delay of fistula closure and temporary fistula radius augmentation, while reduction of intestinal pressure during sub-atmospheric pressure treatment contributes to a faster and direct fistula closure. Conclusion: From the model predictions, we conclude that administration of intestinal pressure decreasing compounds (e.g. butylscopolamine, glucagon) may improve VAC treatment, while intestinal pressure increasing drugs should be avoided.
publishDate 2011
dc.date.none.fl_str_mv 2011
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
Articulo
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://sedici.unlp.edu.ar/handle/10915/84083
url http://sedici.unlp.edu.ar/handle/10915/84083
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/issn/1743-9191
info:eu-repo/semantics/altIdentifier/doi/10.1016/j.ijsu.2011.09.001
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
http://creativecommons.org/licenses/by-nc-sa/4.0/
Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0)
eu_rights_str_mv openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc-sa/4.0/
Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0)
dc.format.none.fl_str_mv application/pdf
662-668
dc.source.none.fl_str_mv reponame:SEDICI (UNLP)
instname:Universidad Nacional de La Plata
instacron:UNLP
reponame_str SEDICI (UNLP)
collection SEDICI (UNLP)
instname_str Universidad Nacional de La Plata
instacron_str UNLP
institution UNLP
repository.name.fl_str_mv SEDICI (UNLP) - Universidad Nacional de La Plata
repository.mail.fl_str_mv alira@sedici.unlp.edu.ar
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