Use of Vacuum-Assisted Closure in the Management of Colostomy

Abstract

Background: This article is the first report of the simultaneous use of vacuum-assisted closure (VAC) therapy and an oral tube applied as a life-saving treatment for colostomy dehiscence to avoid fecal contamination. Case Presentation: A 75-year-old female was admitted to our surgical unit in 2012 for knee trauma caused by an accidental fall at home. Surgery for lysis of adhesions, left colectomy, colorectal anastomosis, and protective ileostomy was performed initially for sigmoidovaginal fistula. Vacuum-assisted closure therapy (applying continuous negative abdominal pressure) was used after median wound dehiscence and a parastomal abscess that caused the necrosis of the skin and subcutaneous tissue surrounding the colostomy. Conclusion: The application of a negative pressure is a novel approach to colostomy dehiscence and complicated abdominal wound management and can lead to complete abdominal wound closure and finally to apply a standard plate for colostomy bag.