Original Article
Clinical effects of negative pressure wound therapy in treating the poor healing of incisions after different abdominal operations
Xuexin Wang, Yang Xiang, Yao Meng, Bing Ma, Xiaoyan Hu, Hongtai Tang, Daofeng Ben, Shichu Xiao
Published 2021-11-20
Cite as Chin J Burns, 2021, 37(11): 1054-1060. DOI: 10.3760/cma.j.cn501120-20210518-00194
Abstract
ObjectiveTo investigate the clinical effects of negative pressure wound therapy (NPWT) in treating the poor healing of incisions after different abdominal operations.
MethodsThe 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.
ResultsThe 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.
ConclusionsNPWT 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.
Key words:
Negative-pressure wound therapy; Abdomen; Postoperative complications; Poor incision healing
Contributor Information
Xuexin Wang
Center of Burns and Trauma, the First Affiliated Hospital, Naval Medical University, Shanghai 200433, China
Yang Xiang
Center of Burns and Trauma, the First Affiliated Hospital, Naval Medical University, Shanghai 200433, China
Yao Meng
Center of Burns and Trauma, the First Affiliated Hospital, Naval Medical University, Shanghai 200433, China
Bing Ma
Center of Burns and Trauma, the First Affiliated Hospital, Naval Medical University, Shanghai 200433, China
Xiaoyan Hu
Center of Burns and Trauma, the First Affiliated Hospital, Naval Medical University, Shanghai 200433, China
Hongtai Tang
Center of Burns and Trauma, the First Affiliated Hospital, Naval Medical University, Shanghai 200433, China
Daofeng Ben
Center of Burns and Trauma, the First Affiliated Hospital, Naval Medical University, Shanghai 200433, China
Shichu Xiao
Center of Burns and Trauma, the First Affiliated Hospital, Naval Medical University, Shanghai 200433, China