子宫内膜癌经耻骨联合上横切口手术后出现广泛脂肪组织坏死。
Extensive adipose tissue necrosis following pfannenstiel incision for endometrial cancer.
作者信息
Lavoie Maryse Céline, Plante Marie, Lemieux Marie-Carine, Roberge Céline, Renaud Marie-Claude, Grégoire Jean, Roy Michel, Sebastianelli Alexandra
机构信息
Gynecologic Oncology Division, Hôtel-Dieu de Québec, Centre hospitalier universitaire de Québec, Quebec City QC.
Enterostomal care, Hôtel-Dieu de Québec, Centre hospitalier universitaire de Québec, Quebec City QC.
出版信息
J Obstet Gynaecol Can. 2014 Mar;36(3):253-7. doi: 10.1016/s1701-2163(15)30634-4.
BACKGROUND
Hematomas are potential postoperative complications that may arise from Pfannenstiel incisions. They usually either resolve spontaneously or are drained depending on their extent. Major risk factors such as obesity and diabetes may lead to superimposed complications and further worsen the outcome.
CASE
A 73-year-old woman presented with a large subcutaneous hematoma 10 days after total abdominal hysterectomy done through a Pfannenstiel incision for endometrial cancer. The hematoma progressed and led to extensive subcutaneous fat necrosis. Extensive debridement was required, and negative pressure wound therapy with gauze was used to allow second intention closure. Satisfactory healing was achieved after 82 days of treatment without skin grafting.
CONCLUSION
This case highlights the usefulness of gauze-based negative pressure wound therapy, as well as the need for a multidisciplinary approach in taking care of such complex wound complication.
背景
血肿是经耻骨联合上横切口手术可能出现的术后潜在并发症。它们通常会自行消退或根据其范围进行引流。肥胖和糖尿病等主要危险因素可能导致叠加并发症并使预后进一步恶化。
病例
一名73岁女性，因子宫内膜癌经耻骨联合上横切口行全腹子宫切除术后10天出现巨大皮下血肿。血肿进展并导致广泛的皮下脂肪坏死。需要进行广泛清创，并使用带纱布的负压伤口治疗以实现二期愈合。经过82天的治疗，未进行植皮，伤口实现了满意愈合。
结论
本病例突出了基于纱布的负压伤口治疗的有效性，以及在处理此类复杂伤口并发症时采用多学科方法的必要性。
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