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Damage Control Surgery with Negative Pressure Wound Theraphy for Impalement Injury of Pelvic and Periproctal Wound

Article information

J Acute Care Surg. 2016;6(2):78-79
Publication date (electronic) : 2016 October 30
doi : https://doi.org/10.17479/jacs.2016.6.2.78
Young Goun Jo, M.D., Ji Woong Yeom, M.D., Yun Chul Park, M.D., Wu Seong Kang, M.D., Jung Chul Kim, M.D.,
Division of Trauma Surgery, Department of Surgery, Chonnam National University Medical School, Gwangju, Korea
Jung Chul Kim, M.D. Department of Surgery, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Korea Tel: +82-62-220-6456, Fax: +82-62-227-1635, E-mail: 3rdvivace@hanmail.net
Received 2016 October 07; Revised 2016 October 18; Accepted 2016 October 19.

본문

A 74-year-old man visited emergency department after cultivator rollover accident. Cultivator handle was directly impalement at left medial thigh area and perianal perineum was penetrated (Fig. 1). Abdominal computed tomography showed penetrating wound at left thigh to perineal area with left ischial fracture (Fig. 2). Foreign body was removed and femoral venorraphy was conducted. Two days later, pad removal and transverse colostomy was formed. After procedure periproctal wound discharge was continued. Under local anesthesia, irrigation and debridement of necrotic periproctal wound was performed. Wound discharge was diminished but pus like oozing was remained. Ten days later, we applied negative pressure wound therapy system by V.A.C therapy (KCI, San Antonio, TX, USA) (Fig. 3). We were set to operate in continuous mode at a pressure of 125 mmHg. Equipment was applied for seven days. After the application of the equipment, partial wound closure was performed. Sixty days after initial surgery, patient was discharged [1,2].

Fig. 1

Cultivator handle was directly impalement at left medial thigh area and perianal perineum was penetrated.

Fig. 2

Abdominal computed tomography showed penetrating wound at left thigh to perineal area with left ischial fracture.

Fig. 3

Ten days later, we applied negative pressure wound therapy system by V.A.C therapy.

References

1. Herscovici D Jr, Sanders RW, Scaduto JM, Infante A, DiPasquale T. Vacuum-assisted wound closure (VAC therapy) for the management of patients with high-energy soft tissue injuries. J Orthop Trauma 2003;17:683–8. 10.1097/00005131-200311000-00004.
2. Ni J, Liu H, Liu X, Zhou L, Sun Y, Shi P, et al. Vacuum sealing drainage as treatment of severe buttocks and perianal infection: a case report and review of the literature (Care-Compliant). Medicine (Baltimore) 2015;94:e1766.

Article information Continued

Copyright: © 2016 by Korean Society of Acute Care Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Fig. 1

Fig. 1

Cultivator handle was directly impalement at left medial thigh area and perianal perineum was penetrated.

Fig. 2

Fig. 2

Abdominal computed tomography showed penetrating wound at left thigh to perineal area with left ischial fracture.

Fig. 3

Fig. 3

Ten days later, we applied negative pressure wound therapy system by V.A.C therapy.