Tokumaru Teppei, Kurata Hideaki, Nakaebisu Rei, Tomioka Joji
Emergency and Critical Care Center Yamaguchi Prefectural Grand Medical Center Hofu Japan.
Department of Acute Medicine and Surgery Yonemori Hospital Kagoshima Japan.
Acute Med Surg. 2023 Nov 27;10(1):e907. doi: 10.1002/ams2.907. eCollection 2023 Jan-Dec.
Surgery for incisional hernias with obesity can be more challenging because obesity is associated with perioperative complications. Necrotizing soft tissue infection (NSTI) is a life-threatening condition that requires aggressive surgical management. Few incisional hernias with NSTI have been reported, and the optimal strategy is undetermined.
A 66-year-old obese woman had been diagnosed with incisional hernia 4 years previously but was not treated. She presented with abdominal pain that had worsened 2 weeks previously. Emergency radical surgery was carried out for an incisional hernia with NSTI. The abdominal fascia was sutured directly without mesh. Negative pressure wound therapy was performed after surgery. The postoperative course was uneventful, without recurrence.
Aggressive surgery is a valid strategy for life-threatening incisional hernias with NSTI. Strategies should be developed based on physiological and anatomical findings.
肥胖患者的切口疝手术可能更具挑战性，因为肥胖与围手术期并发症相关。坏死性软组织感染（NSTI）是一种危及生命的疾病，需要积极的手术治疗。很少有关于伴有NSTI的切口疝的报道，最佳治疗策略尚未确定。
一名66岁肥胖女性4年前被诊断为切口疝，但未接受治疗。她因2周前加重的腹痛前来就诊。对伴有NSTI的切口疝进行了急诊根治性手术。直接缝合腹壁筋膜，未使用补片。术后进行了负压伤口治疗。术后过程顺利，无复发。
对于伴有NSTI的危及生命的切口疝，积极的手术是一种有效的治疗策略。应根据生理和解剖学发现制定治疗策略。
