RN Nursing Staff Coordinator. Raimondo Arena – RN. Antonino Gulino . U.O.C. di Chirurgia Oncologica – A.O. di Rilievo Nazionale e di Alta Specializzazione “Garibaldi” Catania - ITALY

TREATMENT WITH NEGATIVE PRESSURE AND DRAINAGESHEET FOR PERISTOMALE SEVERE COMPLICATION AFTERSIGMA NEOPLASIA IN PATIENTS UNDERGOING DIALYSIS.

WITH NEGATIVE PRESSURE AND DRAINAGE SHEET FOR PERISTOMALE LICATION AFTER SIGMA NEOPLASIA IN PATIENTS UNDERGOING DIALYSIS.

owel operations lead, at the end, to the packaging of a derivation. The evolution of surgical techniques andtage of occurrence of complications varies between 28 and 70%.

a 68-year-old woman undergoing surgery for resection of sigmoid colon-rectum en-bloc with hysterectomys a result of tight stenosis of sigmoid rectum. On the tenth day from surgical act is present peristomal tissue

ct-cutaneous and mucocutaneous fistula from peristomal wound to laparotomy incision, resulting inehiscence.urgical and infectious complication of ostomy with negative pressure device and drainage sheet.

surgical debridement of peristomal tissue, negative pressure was applied with new protective sheet of ansexposed, to remove non-viable tissues, exudates and intestinal contents from peristomal area and at the sametion tissue.32 days at a constant pressure of 125 mmHg; the dressing was performed every 72 hours.

ent with drainage sheet and negative pressure made it possible to manage the peristomal mucosa exposed,mic dehiscence without further complications; drainage sheet protected ansa avoiding the depletion and the

posure.

ovember 2013 Before&After surgical debridement

5 November 2012 First NPWT Dressing

Application of drainage film around bowel loop and inside toundermining and tunnelling. Fill with PU foam and cover withadhesive film. Connect to NPWT pump, apply continuosnegative pressure (125 mmHg) Around ostomy application

November 2012 ( after 7 days of treatment)

ows wound after 2nd dressing change.

November 2012 (13 days of treatment)

Surgeon decided to re - approximatedehiscence edges. Remains undermining. The dressingwas performed by applying “drainage

2 November 2013 (17 days of therapy)

After 5 dressing changes, laparotomic dehiscenceis almost completely healed. There still remains a link with exposed loop.

0 November 2012 (25 days of therapy)

These pictures show wound during the 9th dressingchange. The laparotomic dehiscence is reduced a thintunnel, while undermining to stoma is completely closed.The application of NPWT continues only with a PU Foam.

8 December 2012 ( Interrupted NPWT )

After 32 days of treatment and 10 dressing changes , thiswas the result. Complete healing was obtained after 10 days of collagendressing application.

sions:

mbined treatment with NPWT and drainage sheet :

to obtain fast wound healing ( ± 40 days).

to save the loop exposed, preventing complications tula).

simultaneous management of wounds and ostomy.

es good quality of life to the patient.