Kim Yoonseob, Kim Tae Ah, Hahn Hyung Min, Kang Byung Hee
Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Korea.
J Trauma Inj. 2023 Jun;36(2):152-156. doi: 10.20408/jti.2022.0024. Epub 2022 Nov 4.
Delayed closure of an open abdomen (OA) is a clinically challenging task despite its various modalities. It is substantially more difficult when the duration of OA treatment is prolonged due to a patient's condition. We introduced the management of a patient who had a delayed OA treatment spanning approximately 3 months due to severe abdominal contamination. The 64-year-old male patient had an injured pelvis pressed by a road roller. After visiting a trauma center, the patient initially underwent damage control surgery and OA management; however, early primary abdominal closure failed due to severe peritonitis. After negative pressure wound therapy for several months, an acellular dermal matrix graft followed by a skin graft were successfully used as treatments. A combination of acellular dermal matrix graft, negative pressure wound therapy, and skin graft techniques is a considerable management sequence for patients subjected to delayed OA treatment.
尽管开放性腹腔(OA)的关闭方式多种多样,但延迟关闭仍是一项具有临床挑战性的任务。当由于患者病情导致OA治疗时间延长时,难度会显著增加。我们介绍了一名因严重腹腔污染而延迟OA治疗约3个月的患者的治疗情况。这名64岁的男性患者骨盆被压路机碾压受伤。在前往创伤中心就诊后,患者最初接受了损伤控制手术和OA处理;然而,由于严重的腹膜炎,早期一期腹壁关闭失败。经过数月的负压伤口治疗后,成功使用了脱细胞真皮基质移植,随后进行了皮肤移植。对于接受延迟OA治疗的患者,脱细胞真皮基质移植、负压伤口治疗和皮肤移植技术相结合是一种值得考虑的治疗顺序。