Treating abdominal surgical site infection using NPWT in Abdominal Tuberculosis Patient: A case report

Authors:
Perwira Widianto

Body of Abstract:
Background: Negative pressure wound therapy (NPWT) for abdominal surgical site infection (SSI) is becoming increasingly common, although enterocutaneous fistula (ECF) has been reported as a com plication after abdominal tuberculosis surgery. To avoid ECF, we used computed tomography (CT) abdominal to evaluate the relationship between the wound and the intestine, and then safely treated the abdominal SSI with NPWT.
Case Presentation: a 30-year-old man following a laparoscopic appendectomy for acute appendicitis case. Six days after surgery, we diagnosed ECF. We performed ileostomy because there is leak in terminal ileum 20 cm oral ileocecal valve, pathology result was abdominal tuberculosis. There is also deep SSI, because the wound was deep and the pus resembled enteric fluid Accordingly, we performed NPWT. SSI was cured and the wound was well granulated. Twenty days after surgery, the patient was discharged. Eventually, the wound was completely epithelialized
DISCUSSION: Although successful NPWT has been reported for open abdominal wounds, ECF is a common complication. ECF can be prevented by separating the wound from the intestine by the omentum or muscle fascia, protecting the intestinal serosa during surgery, and applying low vacuum pressure. The relationships among the wound, the fascia, and the intestine must be evaluated before abdominal SSI treatment
CONCLUSION: We report a case of successful NPWT for abdominal SSI in tuberculosis patient