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在资源有限的环境中,我们如何处理造口用品?戈尔巴希地震的经验。

How can we deal with stoma supplies in a resource-limited setting? The Golbasi earthquake experience.

作者信息

Leiritz Elsa, Bernhard Laurent, Orcel Michel, Arnaud Isabelle, Agopian Philippe, Conte Benjamin, Tison Tristan, Malgras Brice, Gaujoux Sebastien

机构信息

Department of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, AP-HP Pitié-Salpêtrière Hospital, Paris, France.

Service Départemental d'Incendie et de Secours (SDIS) du Haut-Rhin, Mulhouse, France.

出版信息

Trauma Case Rep. 2025 Apr 14;57:101172. doi: 10.1016/j.tcr.2025.101172. eCollection 2025 May.

Abstract

INTRODUCTION

In winter 2023, two earthquakes struck southern and central Turkey, resulting in an estimated 56.000 deaths and more than 100.000 persons with injuries. The management of patients presenting post-earthquake injuries and the usual surgical emergencies was highly challenging in these extremes' conditions. This report presents a home-made temporary solution for ostomy care and supplies in a resource-limited setting.

CASE PRESENTATION

A 72-year-old woman, admitted 9 days after the earthquake, presented with a transverse colonic incarceration in a Morgagni-Larrey parasternal diaphragmatic hernia, associated with Hinchey III peritonitis. Extended right colectomy was performed with right ileostomy and left colostomy. A home-made ostomy was designed using as supplies an empty intravenous perfusion bag and transparent film dressings. This cheap, homemade and ready-to-use stoma supply was used during the first 3 postoperative days, without any leak or peri-ostomy skin irritation.

CONCLUSION

In extreme perioperative condition, in a resource-limited setting, ostomy can be temporary equip using a homemade and ready-to-use stoma supply. This equipment is feasible at a low cost in all condition and fit until definitive ostomy supplies can be provided.

摘要

引言

2023年冬季,土耳其南部和中部发生了两次地震,估计造成56000人死亡,10万多人受伤。在这种极端条件下,对地震后受伤患者和常见外科急症患者的管理极具挑战性。本报告介绍了在资源有限的环境中一种自制的临时造口护理及用品解决方案。

病例介绍

一名72岁女性在地震9天后入院,表现为莫尔加尼-拉雷胸骨旁膈疝伴横结肠嵌顿,合并欣奇三级腹膜炎。行扩大右半结肠切除术,同时行右回肠造口术和左结肠造口术。使用空静脉输液袋和透明薄膜敷料作为用品设计了一种自制造口装置。这种廉价、自制且即用型的造口用品在术后头3天使用,未出现任何渗漏或造口周围皮肤刺激。

结论

在极端围手术期条件下,在资源有限的环境中,可使用自制的即用型造口用品临时配备造口装置。该设备在所有情况下成本低廉且可行,可一直使用到能够提供确定性造口用品为止。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48cc/12051646/0cc8d2733104/gr1.jpg

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