А
Dear Surginetters,
49 yo lady. Multiple operations for wound hernia and multiple sepsis. Removal of absorbable prosthesis ( Biogore ) for persistent sepsis and direct repair with relaxing aponeurotic incisions, 3 days ago. Wound disruption today. Repair as a laparostomy and VAC Therapy. Photos attached ( for those who are not familiar with the technique ).
Regards.
Hafez, France.
PS : the change in the color of the foam is due to the Betadine steridrape film ( put for reinforcement ).
Б
Cool Hafez,
what is your plan for the future? How many changes of VAC? Is the patient on ventilator?
We hhad similar case recently, with good result (defect reconstructed with Parietex mesh after 2-3 VAC changes) and continued with VAC because of the skin problems. I can send you some pictures if youre interested
Regards,
jakov
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Jakov,
VAC Changes twice a week for two or three weeks. Then hopefully a standard VAC therapy.
No prosthesis what so ever at the moment. All have been tried apart from biological prostheses. This would be the next option, if accepted by the patient, not before six months anyway.
The patient is going to be kept on ventilator. She has been transferred to the Intensive care unit.
Of course, I am interested. I suppose Surginetters too, especially the newly recruted.
Regards.
Hafez, France
Г
Hi All
I work in an environment where we don't have access to formal VAC
dressings all year round, so we have a lot of experience in managing
these wounds (perhaps not as effectively) with a make shift variation
for the same problem.
Essentially large abdo swabs wrapped in opsite (plastic swabs) then
wrapped around two large calibre NGT's are placed within the wound and
then a opsite placed over to create a seal.
This method is used for a combination of septic wounds (as in this
case), trauma patients who will have a mandated relook within 24 hours
and patients who have loss of domain due to what ever reason.
We try and push dressings to 5 days, this is achieved depending on
amount of effluent. We apply to wall suction with holes cut in
plastic suction tubing to "maintian" a low pressure suction. Patients
usually are awake and in the ward
In my humble experience they usually do well but need time!
Hope this is helpful
Cheers
Nadine
Д
Nadine,
Very interesting to know that this can be achieved this way. Very interesting to know that these patients are awake in the ward.
The next time you do this, take some photos and share. I am sure the kit I used is not available in many countries.
Regards.
Hafez, France.
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