ABSTRACT
The postoperative wound dehiscence is a rare complication of surgical procedures. It is more common among geriatric patients and those undergoing chemotherapy. A more frequent complication is a postoperative bowel obstruction, which also occurred in the presented case. One of the advanced therapeutic techniques in wound infections and complex wound failure (CWF) is the use of negative pressure on the wound surface to improve healing. It is sometimes combined with implantation of monofilament mesh to reconstruct the abdominal wall. A 76-year-old woman diagnosed with ovarian cancer (IV FIGO stage), after chemotherapy, was referred to the Department of Obstetrics, Gynecology and Oncological Gynecology in Bytom for surgical treatment. Postoperative course was complicated by intestinal obstruction and abnormal wound healing with extensive necrosis and fascial dehiscence. Patient required multiple relaparotomies with wound revisions, during which vacuum dressing and monofilament, polypropylene mesh filling the gap in the fascia were implanted. At intervals of 3-4 days, the wound was examined and the dressing was replaced. The mesh was gradually cut, what allowed to bring the fascia edges closer together. During the tenth intervention, the dressing was removed and the skin was sewn. The case illustrates that the combination of using non-absorbable synthetic materials and vacuum assisted closure therapy is highly effective in the treatment of complex wound failures with extensive dehiscence of abdominal wall. The gradual cutting technique of the implantation mesh allows the fascia edges to completely close the wound.
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