Here - EWMA 2013

E-POSTER PRESENTATIONS
EP 580
E-Poster: Case Study
TREATMENT WITH NEGATIVE PRESSURE AND DRAINAGE SHEET FOR
PERISTOMALE SEVERE COMPLICATION AFTER SIGMA NEOPLASIA IN PATIENTS
UNDERGOING DIALYSIS.
Raimondo Arena 1 , Antonino Gulino 1
1 Arnas Garibaldi Chirurgia Oncologica (Catania, Italy).
Demolishing purposes bowel operations lead, at the end, to the packaging of a
derivation. The evolution of surgical techniques and devices used, the percentage of
occurrence of complications varies between 28 and 70%. We describe the case of a
68-year-old woman undergoes surgery for resection of sigmoid colon-rectum en-bloc
with hysterectomy and colostomy terminal as a result of tight stenosis of sigmoid rectum.
On the tenth day from surgical act is present peristomal tissue necrosis with disconnectcutaneous
and mucocutaneous fistula from peristomal wound to laparotomy incision,
resulting in contamination and wide dehiscence.
Objective: Treatment of surgical and infectious complication of ostomy with negative
pressure device and drainage sheet.
Method: After extensive surgical debridement of peristomal tissue, negative pressure
was applied with new protective sheet of anse and peristomal mucosa exposed, to
remove non-viable tissues, exudates and intestinal contents from peristomal area and at
the same time, to stimulate granulation tissue. The treatment lasted for 32 days at a
constant pressure of 125 mmHg; the dressing was performed every 72 hours.
Search Results: Treatment with drainage sheet and negative pressure made it possible
to manage the peristomal mucosa exposed, the fistula and laparotomic dehiscence
without further complications; drainage sheet protected ansa avoiding the depletion and
the consequent tearing by exposure.
Conclusions: The rapid development of granulation tissue associated with bacterial
contamination control has allowed, filling of the fistula between ostomy and laparotomic
lineand the surgical suture for third intention, without the need to revise bowler loop.
E-POSTER: CASE STUDY
EP 581
E-Poster: Case Study
Consecutive reconstructive surgery of trunk, neck and face
deformities after burn injury
Ernest Zacharevskij 1 , Vygintas Kaikaris 1 , Gediminas Samulėnas 1 , Rytis Rimdeika 1
1 Department of Plastic and Reconstructive Surgery, Hospital of Lithuanian University of
Health Scienc (Kaunas, Lithuania).
Introduction: 25 years old man at the age of fifteenth was injured in a fire accident and
underwent long hospital stay and several skin transfer operations. During post injury
period he suffered from residual skin contractures, located in the left armpit region, neck,
face and microoris.
Aim: We represent a case report of successful consecutive reconstructive surgery of
trunk, neck and face deformities after burn injury.
Methods: Reconstructive operations schedule was composed for the patient considering
main complains and major post burn contractures. Festival we performed scar excision
and rotated skin flap in left armpit region to improve left hand elevation and encouraged
the patient in life quality consummation. Next procedure was combined microoris
correction with infranasal region plasty and expander insertion. After three months
expanding there was sufficient skin amount to cover right neck region after neck
contracture elimination. In post-operative periods patient underwent physiotherapy and
scare reducing procedures.
Results: After two years treatment patient got proper left hand elevation, neck rotation
and microoris correction.
Conclusions: Patients after deep skin burns need permanent supervision and an
incentive to start treatment. Well planed consecutive reconstructive surgery significantly
improves life quality of burned patients.
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