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Volume 37 Issue 11
Nov.  2021
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Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  > 2021  >  37(11): 1054-1060
Wang XX,Xiang Y,Meng Y,et al.Clinical effects of negative pressure wound therapy in treating the poor healing of incisions after different abdominal operations[J].Chin J Burns,2021,37(11):1054-1060.DOI: 10.3760/cma.j.cn501120-20210518-00194.
Citation: Wang XX,Xiang Y,Meng Y,et al.Clinical effects of negative pressure wound therapy in treating the poor healing of incisions after different abdominal operations[J].Chin J Burns,2021,37(11):1054-1060.DOI: 10.3760/cma.j.cn501120-20210518-00194.
shu

Clinical effects of negative pressure wound therapy in treating the poor healing of incisions after different abdominal operations

doi: 10.3760/cma.j.cn501120-20210518-00194

  • Center of Burns and Trauma, the First Affiliated Hospital, Naval Medical University, Shanghai 200433, China

Funds:

General Program of National Natural Science Foundation of China 81871559

The 234 Subject Peak Climbing Plan of the First Affiliated Hospital of Naval Medical University 2019YXK045

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  • Corresponding author: Xiao Shichu, Email: huangzhuoxiao4@hotmail.com
  • Received Date: 2021-05-18
    Abstract
  •   Objective  To investigate the clinical effects of negative pressure wound therapy (NPWT) in treating the poor healing of incisions after different abdominal operations.  Methods  The retrospective observational study was conducted. From June 2019 to December 2020, 42 patients with poor healing of incisions after abdominal surgery were admitted to Center of Burns and Trauma of the First Affiliated Hospital of Naval Medical University, including 29 males and 13 females, aged 23-81 years. The disease course of poor healing of abdominal incision was 3-60 d. The preoperative examination of patients was completed after admission, and NPWT was used after debridement. According to the dehiscence level of incision, the negative pressure value of -10.64 to -6.65 kPa was set. The incisions were sutured in the second stage when the incisions had good blood circulation. The cause of abdominal surgery, the dehiscence level and the cause of poor healing of abdominal incision were investigated, and the final healing of abdominal incision and the occurrence of complication were observed.  Results  The causes of abdominal operations in this group of patients who ocurred poor healing of abdominal incisions were ranked according to the composition ratio, with the top 4 causes being colon cancer (9 cases, accounting for 21.4%), bile duct disease (8 cases, accounting for 19.0%), liver cancer (5 cases, accounting for 11.9%), and appendicitis (4 cases, accounting for 9.5%). There were 25 cases (59.5%) with dehiscence of abdominal incision in the deep fascia layer, and the other 17 cases (40.5%) with dehiscence of abdominal incision in the superficial fascia layer. The causes of poor healing of abdominal incision were ranked according to the composition ratio, with the top 3 causes being infection (24 cases, accounting for 57.1%), fat liquefaction (11 cases, accounting for 26.2%), and suture reaction (5 cases, accounting for 11.9%). The blood circulation in 40 patients was improved after being treated with NPWT, and the incisions were sutured in the second stage. The incisions healed well when the suture lines were removed in the second to third week. Intestinal fistula and bile leakage developed during the NPWT treatment, respectively in the other 2 patients, in which negative pressure equipment was removed subsequently, and the incisions healed after adequate drainage and conventional dressing changes.  Conclusions  NPWT is effective in treating poor healing of abdominal incision after different abdominal surgeries. The clinicians need to comprehensively assess the patient's condition to determine when and how to use NPWT to avoid the occurrence of intestinal fistula, bile leakage, and other complications.

     

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