Authors (including presenting author) :
Kwok PY (1), Lee HKA (1), Ku SLO (1), Tsang SM (1), Wong KH (1)
Affiliation :
(1) Stoma and Wound Care, Tseung Kwan O hospital
Keyword 1: :
Negative Pressure Wound Therapy
Introduction :
Surgical site Infection (SSI) and wound dehiscence are known complications after surgery which will always prolong the wound healing time. Negative Pressure Wound Therapy has been widely used for management of different complicated wounds including postoperative surgical wound.
Objectives :
It aims to reduce inflammatory exudate and promote granulation tissue to optimize of wound healing through the application of sub-atmospheric pressure.
Methodology :
A 27-year-old male patient, with past medical history of beta+ thalassaemia and splenectomy was done in Pakistan in 2018, was admitted to surgical ward for post operation care. He was suffered from recurrent cholangitis and underwent an elective Operation - Laparoscopic cholecystectomy (attempted) and converted to Open Cholecystectomy on 24/1/25. His wound was found dehiscence with purulent discharge drained out since 31/1/25. A wound swab was taken for culture on the same day. The culture result was returned with Enterobacter cloacae complex seen. All Stitches have been removed since 31/1/25 for better drainage. Wound care referral was received for post operation surgical wound management on 5/2/25. The wound size on 5/2/25 was 16cm length x2.8cm width x3.5cm depth (LxWxD) with 1.5cm tunnelling at 2 o’clock noted. Wound tissue status was 80% reddish and 20% yellowish. The wound swab was repeated on 12/2/25 and the result was returned with no organism seen. After discussing with surgeon, NPWT started on 14/2/25 with wound size: 15cmx2.7cmx3cm (LxWxD) with undermining at 11-2 o’clock, 3cm deepest at 12 o’clock and stopped on 4/3/25 with wound size was reduced to 14x1.3 x2cm (LxWxD) with undermining filled in. Wound tissue status was 100% reddish. Total 5 times Vacuum-Assisted Closure (VAC) were performed with the frequency twice a week by wound team during the period. Patient’s wound was sutured by surgeon on the same day of stopping VAC.
Result & Outcome :
All stitches were removed at General Outpatient Clinic (GOPC) on 15/3/2025. A wound care nurse clinic appointment was given to patient for continue wound monitoring after patient was discharged from hospital to community. His wound was eventually healed on 31/3/25. This case review shows the successful use of NPWT followed by delayed primary closure with a good clinical outcome in the management of an infected surgical wound.
