Negative pressure wound therapy in the setting of acute abdominal evisceration secondary to major thoracoabdominal burns

TL;DR

This paper describes a new technique using ostomy rings to apply negative pressure wound therapy in a burn patient with abdominal evisceration.

Contribution

A novel method to create a seal for negative pressure wound therapy in burn patients with thoracoabdominal injuries.

Findings

Ostomy/barrier rings enabled successful application of negative pressure wound therapy in a complex burn case.

The technique allowed for temporary abdominal closure and facilitated a second look laparotomy.

This approach may expand the use of negative pressure wound therapy in challenging burn scenarios.

Abstract

Negative pressure wound therapy has allowed for improved management of critical ill patients who requiring abdominal exploration by minimizing operation length, expediting resuscitation, and avoiding unnecessary resections. The use of this vital resource is often limited in burn patients with involvement of the thoracoabdominal wall due to difficulty with maintaining a seal necessary for the negative pressure. This report highlights the case of a 57-year-old patient who sustained significant thoracoabdominal burns and suffered an acute evisceration of small bowel following a debridement. The patient required an emergent return to the operating room and temporary abdominal closure in order to allow for a second look laparotomy. We detail the use of ostomy/barrier rings in order to establish a seal necessary for the negative pressure wound therapy. This novel technique has the potential to expand the use of temporary abdominal closure using negative pressure wound therapy in clinically injured burn patients.

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