Spontaneous Colostomy: Application of Negative Pressure Therapy

The case began with an abdominal suture dehiscence which finished in a spontaneous colostomy. For solving this issue we applied the Negative Pressure Therapy and then we use an Ostomy Care appliance in order to reduce the abdominal cavity.

Aims ·        To close the lesion by second intention
·        Keeping safe the whole peristomal skin
·        Adaptation of an ostomy appliance for collecting the faeces
Method and Material
It is the case of a patient with morbidity obesity, of 58 years who was intervened for the close of the secondary gastric colo- cutaneous fistula. In the post operatory develop a new entero-cutaneous fistula, suture dehiscence and finally a spontaneous colostomy

In a first evaluation of the lesion we observe a dehiscence of surgical suture, with exteriorization of the transversal colon with effluent exit and periestomal skin macerated.

We decided to put a Fistula bag, but due to the aggressively of the faeces effluent which hinder the cicatrization of the cavity we decided to apply the negative pressure therapy. It was made in order to increase the growth of the granulation tissue and for aisle the colostomy from the dehiscence zone. And for reducing the size of the lesion to can apply a colostomy appliance adapt to the periestomal skin.

We keep the Vacuum Assisted Closure during 14 days without any negative impact. It was decided to take away the negative pressure therapy as soon as the dehiscence reduced their size. And then apply an OC device.

Results
We observed a reduction in the size of the cavity in a short period of time due to the application of the Negative Pressure Therapy, and too how a transversal colostomy appeared. During the treatment of the Vacuum therapy, the patient increased her comfort and her independence for auto-care with a significant reduction of the regulated cures.