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腹腔镜胆囊切除术后敷料应用不当导致严重伤口牵引性水泡:一例可预防并发症的病例报告

Severe wound traction-blisters after inadequate dressing application following laparoscopic cholecystectomy: case report of a preventable complication.

作者信息

Sanusi Abayomi L

机构信息

Department of Surgery, York Hospital, Wiggington Road, York, North Yorkshire, YO31 8HE, UK.

出版信息

Patient Saf Surg. 2011 Mar 28;5(1):4. doi: 10.1186/1754-9493-5-4.

Abstract

BACKGROUND

The inadequate application of postoperative dressings can lead to significant complications, including skin injuries, compartment syndromes, and potential limb loss. To our knowledge, the occurrence of post laparoscopic cholecystectomy related skin complications have not yet been reported in the peer-reviewed literature.

CASE PRESENTATION

Following laparoscopic cholecystectomy for symptomatic gallstone disease, a seventy eight year old healthy white male broke out in painful erythema on either side of his epigastric port site. Vesicles akin to a partial thickness burns were revealed upon removal of dressings. An unusual indentation created by the dressing, and skin traction by the dressing's adhesive edges were implicated, raising questions about technique of its application.

CONCLUSION

Incorrect application of wound dressings can disrupt skin architecture, causing painful blistering. This complication should not occur to patients, as it is theoretically 100% preventable. Avoidance of stretching adhesive dressings, and careful adherence to relevant manufacturers' instructions are recommended.

摘要

背景

术后敷料应用不当可导致严重并发症,包括皮肤损伤、骨筋膜室综合征,甚至可能导致肢体丧失。据我们所知,同行评议的文献中尚未报道过腹腔镜胆囊切除术后相关皮肤并发症的发生情况。

病例介绍

一位78岁健康的白人男性因有症状的胆结石疾病接受腹腔镜胆囊切除术后,上腹部切口部位两侧出现疼痛性红斑。去除敷料后发现有类似浅二度烧伤的水疱。敷料造成的异常压痕以及敷料粘性边缘对皮肤的牵拉被认为是病因,这引发了对其应用技术的质疑。

结论

伤口敷料应用不当会破坏皮肤结构,导致疼痛性水疱。这种并发症在理论上是100%可预防的,患者不应出现这种情况。建议避免拉伸粘性敷料,并严格遵守相关制造商的说明。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b176/3076227/b206244cdbcd/1754-9493-5-4-1.jpg

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