This document describes the treatment of a 68-year-old woman undergoing dialysis who developed a severe peristomal complication after surgery for sigmoid colon-rectum resection. She developed a fistula connecting the peristomal wound to the laparotomy incision. The patient was treated with surgical debridement followed by application of negative pressure wound therapy and a protective drainage sheet for 32 days. This combined treatment successfully managed the exposed peristomal tissue, healed the dehiscence without further complications, and protected the bowel loop, resolving the issue within 40 days.

1. RN Nursing Staff Coordinator. Raimondo Arena – RN. Antonino Gulino .
U.O.C. di Chirurgia Oncologica – A.O. di Rilievo Nazionale e di Alta Specializzazione “Garibaldi” Catania - ITALY
TREATMENT WITH NEGATIVE PRESSURE AND DRAINAGE
SHEET FOR PERISTOMALE SEVERE COMPLICATION AFTER
SIGMA NEOPLASIA IN PATIENTS UNDERGOING DIALYSIS.

2. WITH NEGATIVE PRESSURE AND DRAINAGE SHEET FOR PERISTOMALE
LICATION AFTER SIGMA NEOPLASIA IN PATIENTS UNDERGOING DIALYSIS.
owel operations lead, at the end, to the packaging of a derivation. The evolution of surgical techniques and
tage of occurrence of complications varies between 28 and 70%.
a 68-year-old woman undergoing surgery for resection of sigmoid colon-rectum en-bloc with hysterectomy
s a result of tight stenosis of sigmoid rectum. On the tenth day from surgical act is present peristomal tissue
ct-cutaneous and mucocutaneous fistula from peristomal wound to laparotomy incision, resulting in
ehiscence.
urgical and infectious complication of ostomy with negative pressure device and drainage sheet.
surgical debridement of peristomal tissue, negative pressure was applied with new protective sheet of anse
xposed, to remove non-viable tissues, exudates and intestinal contents from peristomal area and at the same
tion tissue.
32 days at a constant pressure of 125 mmHg; the dressing was performed every 72 hours.
ent with drainage sheet and negative pressure made it possible to manage the peristomal mucosa exposed,
mic dehiscence without further complications; drainage sheet protected ansa avoiding the depletion and the
posure.

3. ovember 2013 Before&After surgical debridement

4. 5 November 2012 First NPWT Dressing
Application of drainage film around bowel loop and inside to
undermining and tunnelling. Fill with PU foam and cover with
adhesive film. Connect to NPWT pump, apply continuos

5. November 2012 ( after 7 days of treatment)
ows wound after 2nd dressing change.

6. November 2012 (13 days of treatment)
Surgeon decided to re - approximate
dehiscence edges.
Remains undermining. The dressing
was performed by applying “drainage

7. 2 November 2013 (17 days of therapy)
After 5 dressing changes, laparotomic dehiscence
is almost completely healed. There still remains a
link with exposed loop.

8. 0 November 2012 (25 days of therapy)
These pictures show wound during the 9th dressing
change. The laparotomic dehiscence is reduced a thin
tunnel, while undermining to stoma is completely closed.
The application of NPWT continues only with a PU Foam.

9. 8 December 2012 ( Interrupted NPWT )
After 32 days of treatment and 10 dressing changes , this
was the result.
Complete healing was obtained after 10 days of collagen
dressing application.

10. sions:
mbined treatment with NPWT and drainage sheet :
to obtain fast wound healing ( ± 40 days).
to save the loop exposed, preventing complications
tula).
simultaneous management of wounds and ostomy.
es good quality of life to the patient.