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Ito E, Yoshida M, Nakashima K, et al. New technique for treating abdominal surgical site infection using CT woundgraphy and NPWT: A case report. Int J Surg Case Rep. 2016;21:147-50doi: 10.1016/j.ijscr.2016.03.009.
Ito, E., Yoshida, M., Nakashima, K., Suzuki, N., Imakita, T., Tsutsui, N., Ohdaira, H., Kitajima, M., & Suzuki, Y. (2016). New technique for treating abdominal surgical site infection using CT woundgraphy and NPWT: A case report. International journal of surgery case reports, 21147-50. https://doi.org/10.1016/j.ijscr.2016.03.009
Ito, Eisaku, et al. "New technique for treating abdominal surgical site infection using CT woundgraphy and NPWT: A case report." International journal of surgery case reports vol. 21 (2016): 147-50. doi: https://doi.org/10.1016/j.ijscr.2016.03.009
Ito E, Yoshida M, Nakashima K, Suzuki N, Imakita T, Tsutsui N, Ohdaira H, Kitajima M, Suzuki Y. New technique for treating abdominal surgical site infection using CT woundgraphy and NPWT: A case report. Int J Surg Case Rep. 2016;21:147-50. doi: 10.1016/j.ijscr.2016.03.009. Epub 2016 Mar 14. PMID: 27002290; PMCID: PMC4802333.
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Int J Surg Case Rep. 2016;21:147-50. doi: 10.1016/j.ijscr.2016.03.009. Epub 2016 Mar 14.

New technique for treating abdominal surgical site infection using CT woundgraphy and NPWT: A case report.

International journal of surgery case reports

Eisaku Ito, Masashi Yoshida, Keigo Nakashima, Norihiko Suzuki, Tomonori Imakita, Nobuhiro Tsutsui, Hironori Ohdaira, Masaki Kitajima, Yutaka Suzuki

Affiliations

  1. Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara-city, Tochigi, 329-2763, Japan. Electronic address: [email protected].
  2. Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara-city, Tochigi, 329-2763, Japan. Electronic address: [email protected].
  3. Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara-city, Tochigi, 329-2763, Japan. Electronic address: [email protected].
  4. Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara-city, Tochigi, 329-2763, Japan. Electronic address: [email protected].
  5. Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara-city, Tochigi, 329-2763, Japan. Electronic address: [email protected].
  6. Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara-city, Tochigi, 329-2763, Japan. Electronic address: [email protected].
  7. Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara-city, Tochigi, 329-2763, Japan. Electronic address: [email protected].
  8. Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara-city, Tochigi, 329-2763, Japan. Electronic address: [email protected].
  9. Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara-city, Tochigi, 329-2763, Japan. Electronic address: [email protected].

PMID: 27002290 PMCID: PMC4802333 DOI: 10.1016/j.ijscr.2016.03.009

Abstract

INTRODUCTION: Negative pressure wound therapy (NPWT) for abdominal surgical site infection (SSI) is becoming increasingly common, although enterocutaneous fistula (ECF) has been reported as a complication. To avoid ECF, we used computed tomography (CT) woundgraphy to evaluate the relationship between the wound and the intestine, and then safely treated the abdominal SSI with NPWT.

CASE PRESENTATION: Following a laparoscopic intersphincteric resection for low rectal neuroendocrine tumor and covering ileostomy, a 59-year-old woman underwent stoma closure. Six days after surgery, we diagnosed SSI. We suspected ECF, because the wound was deep and the pus resembled enteric fluid. However, CT woundgraphy showed that the wound was separated from the abdominal cavity and the intestine by the abdominal rectus muscle. Accordingly, we performed NPWT. SSI was cured and the wound was well granulated. Twenty-three days after surgery, the patient was discharged. Eventually, the wound was completely epithelialized.

DISCUSSION: Although successful NPWT has been reported for open abdominal wounds, ECF is a common complication. ECF can be prevented by separating the wound from the intestine by the omentum or muscle fascia, protecting the intestinal serosa during surgery, and applying low vacuum pressure. The relationships among the wound, the fascia, and the intestine must be evaluated before abdominal SSI treatment. One good method is CT woundgraphy, which evaluates wound extent and depth, closure of muscle fascia, and the relationship between the wound and the intestine.

CONCLUSION: We report a case of CT woundgraphy before NPWT for abdominal SSI. CT woundgraphy is a good candidate for evaluating wound condition.

Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Keywords: CT woundgraphy; Negative pressure wound therapy; Surgical site infection

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