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在严重胸腹烧伤继发急性腹部脏器脱出情况下的负压伤口治疗

Negative pressure wound therapy in the setting of acute abdominal evisceration secondary to major thoracoabdominal burns.

作者信息

Crawley William T, Pulikkottil Benson, Busch Maxwell

机构信息

Department of Graduate Medical Education, HCA HealthOne - Swedish Medical Center, 610 E Hampden, Ste 220, Englewood, CO 80113, United States.

HCA HealthOne - Swedish Medical Center, Burn and Reconstructive Center, 610 E Hampden, Ste 310, Englewood, CO 80113, United States.

出版信息

J Surg Case Rep. 2025 Apr 8;2025(4):rjaf203. doi: 10.1093/jscr/rjaf203. eCollection 2025 Apr.

Abstract

Negative pressure wound therapy has allowed for improved management of critical ill patients who requiring abdominal exploration by minimizing operation length, expediting resuscitation, and avoiding unnecessary resections. The use of this vital resource is often limited in burn patients with involvement of the thoracoabdominal wall due to difficulty with maintaining a seal necessary for the negative pressure. This report highlights the case of a 57-year-old patient who sustained significant thoracoabdominal burns and suffered an acute evisceration of small bowel following a debridement. The patient required an emergent return to the operating room and temporary abdominal closure in order to allow for a second look laparotomy. We detail the use of ostomy/barrier rings in order to establish a seal necessary for the negative pressure wound therapy. This novel technique has the potential to expand the use of temporary abdominal closure using negative pressure wound therapy in clinically injured burn patients.

摘要

负压伤口治疗通过缩短手术时间、加快复苏以及避免不必要的切除,改善了需要进行腹部探查的危重症患者的管理。由于难以维持负压所需的密封,这种重要资源在胸腹壁烧伤患者中的使用往往受到限制。本报告重点介绍了一名57岁患者的病例,该患者遭受了严重的胸腹烧伤,在清创后小肠急性外露。患者需要紧急返回手术室并进行临时腹部闭合,以便进行二次剖腹探查。我们详细介绍了使用造口/屏障环来建立负压伤口治疗所需的密封。这种新技术有可能扩大负压伤口治疗在临床烧伤患者中临时腹部闭合的应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b21d/11976713/bd9371bd9527/rjaf203f1.jpg

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