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剖腹术后感染伤口采用负压封闭引流术取得良好效果:一例病例报告。

Well-promising outcomes with vacuum-assisted closure in an infected wound following laparotomy: A case report.

作者信息

Daskalaki A, Xenaki S, Venianaki M, Topalidou A, Athanasakis E, Chrysos E, Chalkiadakis G

机构信息

Department of General Surgery, University Hospital of Heraklion, Crete-Greece.

Faculty of Medicine, University of Crete, Greece.

出版信息

Ann Med Surg (Lond). 2016 Aug 2;10:73-6. doi: 10.1016/j.amsu.2016.07.027. eCollection 2016 Sep.

Abstract

INTRODUCATION

Negative pressure wound therapy (NPWT) represents an alternative method to optimize conditions for wound healing. Delayed wound closure is a significant health problem, which is directly associated with pain and suffering from patient's aspect, as well with social and financial burden.

PRESENTATION OF CASE

We report a case of vacuum-assisted wound therapy with hypertonic solution distillation and continuous negative pressure application, in an infected wound after laparotomy for incisional hernia reconstruction with mesh placement. Negative pressure was initiated at the wound margins after failure of conventional treatment with great outcomes, achieving a total closure of the incision within two weeks.

DISCUSSION

Each wound has particular characteristics which must be managed. Vacuum assisted closure (VAC) with continuous negative pressure and simultaneous wound instillation and cleanse can provide optimum results, reducing the cavity volume, by newly produced granulated tissue.

CONCLUSION

The simultaneous use of instillation and constant pressure seemed to be superior in comparison with NPWT alone. Compared to conventional methods, the use of VAC ends to better outcomes, in cases of infected wounds following laparotomy.

摘要

引言

负压伤口治疗(NPWT)是一种优化伤口愈合条件的替代方法。伤口延迟闭合是一个严重的健康问题,从患者角度来看,它与疼痛和痛苦直接相关,同时也带来社会和经济负担。

病例介绍

我们报告一例在放置补片进行剖腹手术切口疝重建后出现感染伤口的病例,采用高渗溶液蒸馏和持续负压应用的真空辅助伤口治疗。在传统治疗失败后,于伤口边缘开始施加负压,取得了良好效果,在两周内实现了切口的完全闭合。

讨论

每个伤口都有其必须处理的特殊特征。持续负压、同时进行伤口灌注和清洁的真空辅助闭合(VAC)可通过新生成的肉芽组织减少腔隙体积,从而提供最佳效果。

结论

与单独使用NPWT相比,同时使用灌注和恒压似乎更具优势。在剖腹手术后感染伤口的病例中,与传统方法相比,使用VAC能带来更好的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d00/4990566/84afc4ad4411/gr1.jpg

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