A Novel Negative Pressure Therapy Technique to Manage a Colo-Cutaneous Fistula following Emergency Aortic Surgery

Abstract

Negative pressure wound therapy (NPWT) is a well-established technique for managing the open abdominal wound. The decision to intentionally leave an abdominal incision open may be required in the aftermath of surgery for intra-abdominal sepsis or where there is concern regarding abdominal compartment syndrome (ACS). Untreated ACS following elective, or emergency abdominal aortic aneurysm repair (AAA) is associated with mortality rates of up to 60% [1]. Management of the open abdomen, particularly in obese patient, is challenging and labour-intensive. The aim of wound management in this setting is to contain drainage, manage the peri-wound skin and facilitate closure of the wound. This case report discusses the successful management of a complex abdominal wound in a morbidly obese patient complicated by a colo-cutaneous fistula following emergency abdominal aortic aneurysm repair.