Therapeutic management in polytrauma patient with prolonged laparostomy

Mirela Sărăndan¹, Carmen Alina Cradigati¹, S. Chiriac², B. Ţunescu², Z. Crăiniceanu³, Mihaela Măstăcăneanu³, F. Negrea¹, D. Săndesc ⁴

1 Compartimentul Anestezie şi Terapie Intensivă „Casa Austria”, Spitalul Judeţean de Urgenţă Timişoara
2 Compartimentul Politraumatologie „Casa Austria”, Spitalul Judeţean de Urgenţă Timişoara
3 Clinica de Chirurgie Plastică şi Reparatorie „Casa Austria”, Spitalul Judeţean de Urgenţă Timişoara
4 Clinica Anestezie şi Terapie Intensivă, Spitalul Judeţean de Urgenţă Timişoara

Abstract

Introduction. Therapeutic management of laparostomy in polytrauma patients in level-I trauma centers is done by coverage with vacuum assisted closure (VAC) dressing. Control of septic complications is essential for survival.
Case report. We present the case of a 23 years old patient, victim of a road accident with major abdo­minal trauma, with laparostomy maintained 28 days. We performed abdominal fascia replacement with polypropilene mesh and continuous aspiration under self adhesive drape associated with prolongued intensive therapy. The patient survived, with pro­gressive total repair of abdominal wall.
Conclusion. Implementation of modern techniques for open abdomen treatment is mandatory in polytrauma patient.
Keywords: polytrauma, “damage control surgery”, laparostomy, vacuum assisted closure

J Rom Anest Terap Int 2010; 17: 61-64

CAZURI CLINICE

Managementul terapeutic în politraumatismul cu laparostomie prelungită