Johnson Kylie, Williams Ben, Steen Eric
Lewis Gale Medical Center, Edward Via College of Osteopathic Medicine, Blacksburg, VA 24060, USA.
J Surg Case Rep. 2021 Jan 18;2021(1):rjaa562. doi: 10.1093/jscr/rjaa562. eCollection 2021 Jan.
This case of bowel obstruction with multiple postoperative complications provides unique insight into the challenges faced by providers caring for intellectually disabled patients with acute surgical abdominal pathology and poor compliance. In this case, the component separation was utilized as a method of facilitated wound closure and compliance in a postoperative course highlighted by both dehiscence and wound infection. The patient, only able to communicate the presence of abdominal pain due to his disability, was surgically managed for a bowel obstruction secondary to a cecal volvulus. The difficulty in initial communication and patient noncompliance help illustrate the individualized care these patients require. This report will demonstrate both the challenges present in the management of intellectually disabled patients with abdominal wounds, as well as the use of component separation in providing both initial wound closure and continued wound integrity with the goal of reducing postoperative complications in patients with decreased compliance.
这例伴有多种术后并发症的肠梗阻病例,为护理患有急性外科腹部疾病且依从性差的智障患者的医护人员所面临的挑战提供了独特的见解。在本病例中,在以伤口裂开和伤口感染为突出特点的术后过程中,采用了成分分离术作为促进伤口闭合和提高依从性的方法。该患者因残疾只能表达腹痛,因盲肠扭转继发肠梗阻而接受手术治疗。初始沟通困难和患者不依从有助于说明这些患者所需的个性化护理。本报告将展示在处理智障腹部伤口患者时所面临的挑战,以及使用成分分离术进行初始伤口闭合和维持伤口完整性,以减少依从性降低患者术后并发症的情况。