Nakao Shigetomi, Ogawa Masafumi, Nakagawa Yasuo, Yamamoto Tokihiko
Dept. of Surgery, Yamamoto Daisan Hospital.
Gan To Kagaku Ryoho. 2021 Feb;48(2):276-278.
We report a case of infected and incised wound cured by negative pressure wound therapy with instillation and dwelling (NPWTi-d)after right hemicolectomy for ascending colon cancer. The patient was a 72-year-old male. An ascending colon cancer with abdominal wall invasion and enterocutaneous fistula was found. We performed the right hemicolectomy and debridement of abdominal wall for the patients. However, the leakage of ileum-transverse colon anastomosis was found on postoperative day 3. We performed the resection of anastomosis and ileostomy. Nevertheless, 2 days after second operation, the abdominal wall of debridement became open by infection, and the small intestine was exposed. As the surgical treatment and NPWT was thought to be difficult because of infection, we started NPWTi-d on day 4 after second operation. 25 day after starting NPWTi-d, benign granulation covered the small intestine. NPWTi-d may be useful for wound dehiscence after surgery in infectious conditions.
我们报告了一例升结肠癌右半结肠切除术后，通过滴注式负压伤口治疗（NPWTi-d）治愈感染性切开伤口的病例。患者为一名72岁男性。发现患有伴有腹壁侵犯和肠皮肤瘘的升结肠癌。我们为该患者实施了右半结肠切除术和腹壁清创术。然而，术后第3天发现回肠-横结肠吻合口漏。我们进行了吻合口切除和回肠造口术。尽管如此，第二次手术后2天，清创的腹壁因感染而裂开，小肠外露。由于感染，手术治疗和NPWT被认为困难，我们在第二次手术后第4天开始使用NPWTi-d。开始NPWTi-d治疗25天后，良性肉芽覆盖了小肠。NPWTi-d可能对感染情况下手术后的伤口裂开有用。
