Open Abdomen Negative Pressure Device Applied for Two-stage Closure of Enterocutaneous Fistula
| Autor: | Yusuke Yamamoto, Kou Fujisawa, Maki Kitatsuji |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Enterocutaneous fistula
medicine.medical_specialty business.industry medicine.medical_treatment Perforation (oil well) lcsh:Surgery Case Report lcsh:RD1-811 Rectus sheath Abdominal cavity 030230 surgery Reconstructive Surgery 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Fascia lata 030220 oncology & carcinogenesis Negative-pressure wound therapy Medicine business Complication Abdominal surgery |
| Zdroj: | Plastic and Reconstructive Surgery Global Open Plastic and Reconstructive Surgery, Global Open, Vol 9, Iss 2, p e3369 (2021) |
| ISSN: | 2169-7574 |
| Popis: | Summary:. Enterocutaneous fistula (ECF), which is an abnormal connection between the gastrointestinal tract and skin, is a serious complication of abdominal surgery, and a multidisciplinary approach is required for its treatment. Here, we report the case of a 46-year-old woman who had a large ECF measuring 6 × 12 cm that was successfully treated with a 2-stage surgery. After the first surgery of intestinal wall reconstruction, an abdominal negative pressure wound therapy (NPWT) device was administered to facilitate the reexploration of the abdominal cavity. On postoperative day 5, intestinal perforation and abdominal cavity infection were found during dressing change and were immediately repaired. Subsequently, after 10 days of abdominal NPWT, the second surgery comprising abdominal wall reconstruction was performed using a pedicled anterolateral thigh flap (8 × 19 cm) combined with the fascia lata (12 × 20 cm). The defective rectus sheath and skin were uneventfully closed with the fascia lata and flap skin paddle, respectively. In the follow-up after 7 months, ECF had not recurred. The abdominal NPWT device enabled easy reentry of the abdominal cavity and reduced the size of the flap needed to cover the defect. Moreover, open abdominal management can be performed consistently, independent of the surgeon’s expertise. Therefore, this report suggests that 2-stage surgery with abdominal NPWT management is a useful strategy for ECF treatment. |
| Databáze: | OpenAIRE |
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