Temporary Diverting End-Colostomy in Critically Ill Children with Severe Perianal Wound Infection.

Autor:	Gün E; At the Ankara University School of Medicine, Turkey, Emrah Gün, MD, is Fellow, Department of Pediatric Critical Care Medicine; Tanil Kendirli, MD, is Professor, Department of Pediatric Critical Care Medicine; Edin Botan, MD, is Fellow, Department of Pediatric Critical Care Medicine; Halil Özdemir, MD, is Associate Professor, Department of Pediatric Infectious Disease; Ergin Çiftçi, MD, is Professor, Department of Pediatric Infectious Disease; Kübra Konca, MD, is Fellow, Department of Pediatric Infectious Disease; Meltem Koloğlu, MD, is Professor, Department of Pediatric Surgery; Gülnur Göllü, MD, is Associate Professor, Department of Pediatric Surgery; Özlem Selvi Can, MD, is Associate Professor, Department of Pediatric Anesthesia; Ercan Tutar, MD, is Professor, Department of Pediatric Cardiology; Ahmet Rüçhan Akar, MD, is Professor, Department of Cardiovascular Surgery, Heart Center, Cebeci Hospitals; and Erdal İnce, MD, is Professor, Department of Pediatric Infectious Disease. Acknowledgments: The authors wish to thank all the pediatric ICU nursing staff for all their efforts and support for our critically ill pediatric patients. The authors have disclosed no financial relationships related to this article. Submitted June 24, 2020; accepted in revised form September 25, 2020., Kendirli T, Botan E, Özdemir H, Çiftçi E, Konca K, Koloğlu M, Göllü G, Can ÖS, Tutar E, Akar AR, İnce E
Jazyk:	angličtina
Zdroj:	Advances in skin & wound care [Adv Skin Wound Care] 2021 Jun 01; Vol. 34 (6), pp. 322-326.
DOI:	10.1097/01.ASW.0000744332.84964.0f
Abstrakt:	Abstract: Broad and deep perianal wounds are challenging in both adult and pediatric ICUs. These wounds, if contaminated with gastrointestinal flora, can cause invasive sepsis and death, and recovery can be prolonged. Controlling the source of infection without diverting stool from the perianal region is complicated. The option of protective colostomy is not well-known among pediatric critical care specialists, but it can help patients survive extremely complicated critical care management. These authors present three critically ill children who required temporary protective colostomy for perianal wounds because of various clinical conditions. Two patients were treated for meningococcemia, and the other had a total artificial heart implantation for dilated cardiomyopathy. There was extensive and profound tissue loss in the perianal region in the patients with meningococcemia, and the patient with cardiomyopathy had a large pressure injury. Timely, transient, protective colostomy was beneficial in these cases and facilitated the recovery of the perianal wounds. Temporary diverting colostomy should be considered as early as possible to prevent fecal transmission and accelerate perianal wound healing in children unresponsive to local debridement and critical care. (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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