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在复杂腹部创伤病例中使用瘘管真空辅助闭合(VAC)技术治疗肠-大气瘘(EAF)

Management of Enteroatmospheric Fistula (EAF) Using a Fistula-Vacuum Assisted Closure (VAC) in a Complicated Abdominal Trauma Case.

作者信息

English Connor J, Sodade Oluwafolaranmi E, Austin Cindy L, Hall Jason L, Draper Brian B

机构信息

Trauma Surgery, A.T. Still University - Kirksville College of Osteopathic Medicine, Kirksville, USA.

Trauma Research, Mercy Hospital, Springfield, MO, USA.

出版信息

Cureus. 2023 Apr 17;15(4):e37668. doi: 10.7759/cureus.37668. eCollection 2023 Apr.

Abstract

Enteroatmospheric fistula (EAF) is a relatively rare complication of patients undergoing open abdomen (OA) for damage control surgery. Mortality rates are high due to the increased risk of peritonitis, intraabdominal abscess, sepsis, and new perforations. There are a wide range of EAF management therapies in the literature, however, there are limited options on cases involving fistula-vaccum assisted closure (VAC) therapy. This case describes the treatment course of a 57-year-old, male admitted for blunt abdominal trauma secondary to a motor vehicle accident. Upon admission the patient underwent damage control surgery. The surgeons elected to have the patient's abdomen open, applying a mesh to promote healing. After several weeks of hospitalization an EAF was discovered in the abdominal wound subsequently managed by utilizing a fistula-VAC technique. Based on the successful outcome of this patient, fistula-VAC was shown as an effective way to promote wound healing while reducing the chances of complications.

摘要

肠-腹壁瘘(EAF)是接受开放性腹腔(OA)损伤控制手术患者相对罕见的并发症。由于腹膜炎、腹腔内脓肿、败血症和新穿孔风险增加,死亡率很高。文献中有多种EAF管理疗法,然而,涉及瘘管-负压封闭引流(VAC)疗法的病例选择有限。本病例描述了一名57岁男性因机动车事故导致钝性腹部创伤入院后的治疗过程。入院时患者接受了损伤控制手术。外科医生选择让患者的腹部敞开,应用网片促进愈合。住院几周后,在腹部伤口发现了一个EAF,随后采用瘘管-VAC技术进行处理。基于该患者的成功结果,瘘管-VAC被证明是促进伤口愈合同时降低并发症几率的有效方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3281/10189562/00baedce6298/cureus-0015-00000037668-i01.jpg

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