关键词: 封闭式负压引流, 肠外瘘, 内引流, 术口裂开, 重症

Abstract:

 Objective To report the clinical experience and experience of treatment of abdominal incision dehiscence of small bowel by vacuum sealing drainage. Methods A 60-year-old male patient who suffered from perirenal liposarcoma, underwent resection of perirenal liposarcoma, left nephrectomy liposarcoma and colon resection. After the first operation, the patient underwent colostomy because of complication postoperative anastomotic leakage. When this patient was admitted to our hospital, he had abdominal infection, abdominal incision dehiscence associated with viscera exposure, subcutaneous abscess, septic shock and multiple organ dysfunction. Combined with standard systemic treatment, negative pressure wound therapy （NPWT） recovered abdominal exudate, protected exposed organs, protected surrounding of skin incision and treated incision infection. New complications of small bowel fistula occurred during treatment. The complication of small intestinal fistula was treated by internal drainage tube, silica gel block and NPWT in the small intestine Results Patient s symptoms of systemic infection, internal environment and intestinal function were gradually improved after one month. Then the incision was gradually suture. The complications of the new small intestinal fistula were treated by small intestinal drainage tube and negative pressure drainage. After 9 months without parenteral nutrition, the patient underwent surgical resection of small intestine fistula. Conclusion NPWT can be used for treatment of full-thickness wound dehiscence associated symptoms of internal organs exposure, abdominal wall difficult to be sutured within short time and severe abdominal infection after operation.

Key words: negative pressure wound therapy（NPWT）, intestinal fistula, severe, wound dehiscence, internal drainage