Effective Combination of a Locally Closed-Drainage System and Negative Pressure Wound Therapy for a Wide Postoperative Infectious Seroma After Stoma Closure:A Case Report
2022 Volume 38 Issue 2 Pages 60-67
Details
2022 Volume 38 Issue 2 Pages 60-67
Background: A case of a wide postoperative infectious seroma after stoma closure combined with an incisional hernia repair is presented. It was successfully treated with sequential combination therapy involving a locally closed-drainage system (LCDS), followed by negative-pressure wound therapy (NPWT).
Cases: The patient was a 59-year-old man who underwent Hartmann's operation for rectal cancer, after which a postoperative incisional hernia developed. Stoma closure and repair of the incisional hernia, which required wide subcutaneous undermining around the midline incision, were performed. At the surgery, a subcutaneous drain was placed for the wide subcutaneous space around the midline incision, and the stoma site was semi-closed with a purse-string suture. After the surgery, a wide infectious seroma developed around the semi-closed stoma closure wound and was difficult to treat.
On postoperative day (POD) 10, therefore, continuous drainage therapy with LCDS was started for the seroma. On POD 17, the subcutaneous space was significantly reduced with the LCDS, which was then followed by NPWT to cure the semi-closed stoma closure wound. The wound was completely healed on POD 30.
Discussion & Conclusion: Sequential combination therapy with LCDS followed by NPWT seems effective and useful for the treatment of a complex wide infectious seroma.
