2018 Volume 38 Issue 3 Pages 555-558
A 76-year-old woman was injured in a traffic accident and was diagnosed as having hemorrhagic shock due to injury to her diaphragm, liver, and kidney, and fractures of the pelvis, left femur, right tibia, and fibula. She was transported to our hospital where she underwent external fixation for her left femoral and pelvic fracture on day 1 and an open reduction and internal fixation for the pelvic fracture on day 7. Her general condition worsened on day 11 with leakage of fecal fluid from the pelvic drain. Following a laparotomy, we performed open abdominal management (OAM) with vacuum packing closure (VPC) under the diagnosis of a small intestinal perforation. On day 14, because of drainage failure, we changed from VPC to vacuum assisted closure (VAC). Although we performed anastomosis of the intestinal tract on day 17, she underwent an ileostomy for postoperative suture failure on day 22. VAC was discontinued on day 53, and she was transferred on day 125. Drainage failure observed in cases of OAM necessitates changing from VPC to VAC.