Ishida Kenichiro, Noborio Mitsuhiro, Nishimura Tetsuro, Ieki Yohei, Shimahara Yumiko, Sogabe Taku, Ehara Naoki, Saoyama Yuki, Sadamitsu Daikai
Traumatology and Critical Care Medical Center Osaka National Hospital Osaka Japan.
Acute Med Surg. 2015 Jun 30;3(2):128-131. doi: 10.1002/ams2.135. eCollection 2016 Apr.
A 53-year-old woman developed septic shock associated with non-clostridial gas gangrene. She presented to the emergency department with two large open wounds on both thighs and in her sacral region. Non-enhanced computed tomography showed air density in contact with the right iliopsoas, which extended to the posterior compartment of the thigh. We made repeated efforts at surgical debridement of the wound with resection of necrotic tissues.
Using negative pressure wound therapy-assisted dermatotraction, the pus pockets and the wound dehiscence decreased in size. Using this method we were successful in achieving delayed closure without skin grafts.
Negative pressure wound therapy can be an effective treatment for large and infected open contoured wounds. Negative pressure wound therapy-assisted dermatotraction might be beneficial for poorly healing, large, open wounds in patients in poor condition and with insufficient reserve to tolerate reconstructive surgery.
一名53岁女性发生与非梭菌性气性坏疽相关的感染性休克。她因双大腿及骶部有两处大的开放性伤口而就诊于急诊科。非增强计算机断层扫描显示与右侧髂腰肌接触处有气体密度影,延伸至大腿后间隙。我们多次努力对伤口进行手术清创并切除坏死组织。
采用负压伤口治疗辅助皮肤牵引,脓腔和伤口裂开面积减小。使用这种方法,我们成功实现了延迟闭合且无需植皮。
负压伤口治疗对于大的、感染性开放性轮廓伤口可能是一种有效的治疗方法。负压伤口治疗辅助皮肤牵引对于愈合不良、大的开放性伤口且身体状况较差、储备不足无法耐受重建手术的患者可能有益。