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NEGATIVE PRESSURE WOUND THERAPY [NPWT] IN POSTOPERATIVE PANCREATIC FISTULA: A NOVEL APPROACH
Author(s) -
Shelat V.,
Diddapur R.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04122_16.x
Subject(s) - medicine , negative pressure wound therapy , pancreatic fistula , surgery , pancreatic duct , fistula , pancreas , pancreatitis , alternative medicine , pathology
Incidence of postoperative pancreatic fistula can be as high as up to 25%, especially when operating on a soft pancreas with non‐dilated pancreatic duct. 1 Pancreatic fistula is usually managed expectantly. NPWT is a new dressing method for wound care. NPWT has been used for enterocutaneous fistulas. 2 Use of NPWT in managing pancreatic leak is a novel approach and as yet unreported. Aim We propose the use of NPWT in selected cases of postoperative low output external pancreatic fistulas. Case Report 47‐year‐old male was diagnosed with mucinous cystic neoplasm of pancreas. He had three surgeries in past for choledochal cyst and developed an incisional hernia. He underwent Whipple’s procedure. He developed a polymicrobio‐fungal wound infection. On post‐operative day 7 he developed a low output pancreatic leak with wound fluid amylase of >15,000 units. He was managed with NPWT at 50 mmHg pressure. The dressing was changed by wound care nurse every 48 hours. Result The pancreatic leak settled in 5 days after the use of NPWT. There was no skin excoriation and wound discomfort. NPWT was continued in view of wound infection. Wound granulated well. Conclusion NPWT can be used successfully in postoperative low output external pancreatic fistulas. Use of NPWT has to be explored further before recommending it routinely and for use in high output pancreatic fistulas.