Open AccessManagement of a Pelvic Abscess and Abdominal Fistula after Palliative Total Pelvic Exenteration with Intraoperative Radiotherapy in Recurrent Rectal Cancer Without NPWT: A Case Report
Author(s) -
Hui Yang,
Rui Yang,
Hong Chen
Publication year - 2021
Publication title -
advances in skin and wound care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 61
eISSN - 1538-8654
pISSN - 1527-7941
DOI - 10.1097/01.asw.0000797964.31949.b4
Subject(s) - medicine , surgery , pelvic exenteration , fistula , radiation therapy , abscess , abdominal surgery , negative pressure wound therapy , pathology , alternative medicine
A 59-year-old man with recurrent rectal cancer and type 2 diabetes mellitus underwent palliative total pelvic exenteration and intraoperative radiotherapy. After surgery, he experienced a pelvic abscess and abdominal-perineal fistula. Profuse exudate contaminated the midline abdominal incision through the abdominal-perineal fistula and delayed healing. Because of a residual tumor and the high cost, negative-pressure wound therapy was not performed. After 76 days of local treatment that involved removing necrotic tissue, controlling inflammation with an antimicrobial silver dressing, absorbing and draining exudate with a hypertonic saline dressing, promoting granulation and preventing infection with a silver alginate dressing, and promoting re-epithelialization with recombinant human epidermal growth factor gel, the abdominal wound and abdominal-perineal fistula healed successfully.