Raykha Christina, Botros Amir Sameh Riad, Roden Yasmine, Murchan Peter
General Surgery, South Tipperary General Hospital, Clonmel, IRL.
Cureus. 2018 Dec 13;10(12):e3728. doi: 10.7759/cureus.3728.
Parastomal herniation is a common complication following stoma creation, necessitating surgical repair in up to one-quarter of cases, including emergency cases of incarceration or strangulation. Following hernia repair with or without mesh placement, surgical sites are at risk of infection post-operatively and this is typically resolved by removing the mesh, which can be technically challenging. Few studies have assessed conservative management options for these types of cases. Here, we present a case where negative pressure wound therapy (NPWT) with instillation was utilized for secondary intention healing of a large abdominal wound (20 cm x 23 cm x 5 cm) following mesh infection post-parastomal hernia repair. The patient's wound was completely healed after eight weeks and she had no long-term complications at the one-year follow-up. NPWT with instillation is an option for the conservative management of large abdominal wounds, which can be considered on a case-by-case basis.
造口旁疝是造口术后常见的并发症，多达四分之一的病例需要手术修复，包括嵌顿或绞窄的急诊病例。在进行有或没有放置补片的疝修补术后，手术部位术后有感染风险，通常通过取出补片来解决，这在技术上可能具有挑战性。很少有研究评估这类病例的保守治疗方案。在此，我们报告一例在造口旁疝修补术后补片感染后，采用滴注式负压伤口治疗（NPWT）促进一个大的腹部伤口（20 cm×23 cm×5 cm）二期愈合的病例。患者的伤口在八周后完全愈合，在一年的随访中没有出现长期并发症。滴注式NPWT是保守治疗大腹部伤口的一种选择，可根据具体情况考虑。
