ABDOMINAL WALL CATASTROPHE, THERAPEUTIC STRATEGY – A CASE REPORT AND REVIEW OF THE LITERATURE

Authors

  • Maria João Amaral Serviço de Cirurgia Geral, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal  http://orcid.org/0000-0002-7494-3218
  • Marco Serôdio Serviço de Cirurgia Geral, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal  http://orcid.org/0000-0001-6661-4468
  • Sara Ramos Serviço de Cirurgia Plástica e Reconstrutiva, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal http://orcid.org/0000-0002-2044-6267
  • António Manso Serviço de Cirurgia Geral, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal  http://orcid.org/0000-0002-8914-6959
  • Henrique Alexandrino Serviço de Cirurgia Geral, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (iCBR) area of Environment, Genetics and Oncobiology (CIMAGO), Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal  http://orcid.org/0000-0002-0279-9659
  • José Guilherme Tralhão Serviço de Cirurgia Geral, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (iCBR) area of Environment, Genetics and Oncobiology (CIMAGO), Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal  http://orcid.org/0000-0002-5641-6975

DOI:

https://doi.org/10.34635/rpc.845

Keywords:

abdominal wall reconstruction, porcine dermis, negative wound pressure therapy, skin grafts

Abstract

A complete abdominal wall defect (AWD) is life-threatening, has a functional and cosmetic impact on patients’ quality of life and represents a significant challenge for surgeons, requiring a multidisciplinary treatment strategy. The goals of the reconstructive surgery in the management of these defects are to provide stable coverage of the abdominal contents, restore function and achieve complete wound closure. We present a case that shows that the use of a biological mesh (porcine dermis), negative wound pressure therapy (NPWT) and split skin grafting is suitable to manage such defects when visceral exposure is present. A biological mesh is a good and less aggressive alternative to the use of free flaps, closing the AWD in a tension-free manner in an infected field or in one that is suspected of being infected and it has been shown to be better tolerated than synthetic meshes in open abdomens, with the ability to provide vascular ingrowth and incorporate itself into the native tissue. On the other hand, NPWT showed to provide a firm bandage for the patient and a closed, moist environment, protected from the invasion of bacteria, while eliminating excessive exudation, stimulating angiogenesis and reducing the wound surface area. 

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References

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Published

2022-03-15

Issue

No. 52 (2022): Número 52 - Janeiro 2022

Section

Clinical Case

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