The successful Use of a Negative Pressure Wound Therapy System in the Promotion of Wound Closure in a Complex Patient

The successful use of a negative pressure wound therapy system in the promotion of wound closure in a complex patient.      Our patient is a forty eight year old female who was admitted to our facility with major complications following ventral hernia repair at an outside hospital.  She had a large abdominal wound , an enterocutaneous fistula within the wound, and a non-functioning ileostomy  .
     Initially, the problem was drainage control which was addressed with  an unique large wound manager with an air filled chamber and a removable window providing easy access to the wound.
     After repair of the fistula, the ileostomy began functioning which  required a separate pouching system. The problem now became wound closure which was facilitated by the application of a negative pressure therapy system. The surgeons utilized a synthetic mesh material to achieve wound closure over the exposed bowel. To prevent drying of the mesh, a hydrogel  was applied with a non-adherent dressing  under the negative pressure therapy dressing.
     Soon, red granulation tissue could be visualized through the mesh which indicated a successful graft procedure.
     The negative pressure therapy dressing was changed every three days as was the ostomy appliance for the month our patient was hospitalized.
     The successful management of this patients wound is tantamount to the efficacy of this treatment. . There is a plethora of evidence surrounding the use of negative pressure wound therapy in its current indications, but, it is important to continually expand on this bank of evidence by sharing best practice.
     Our patient became alert and responsive after  three  weeks on a ventilator in our SICU. She was then discharged to an extended care facility.