This case is of an 80-year-old female with BMI of 32.8 kg/m2 who came through the hospital doors with Chronic kidney failure. This patient had previously received a kidney transplant however the transplant had failed. Upon arrival patient was in septic shock which is the last and most severe stage of sepsis. Sepsis occurs when your immune system has an extreme reaction to an infection and the body attacks itself which causes inflammation throughout the body and leads to tissue damage, organ failure and in some cases even death. During Septic shock the body goes into organ failure and the blood pressure becomes dangerously low. The CT scan of the abdomen revealed free air, free fluid, perforated (pierced) last portion of the large intestine.
At the end of first operation
After initial AbClo Placement at Bedside in ICU
After Primary fascial Closure
Patient was taken to the Operating Room for Operative management. Upon exploration of the abdominal cavity findings revealed perforated (pierced) last portion of the large intestine and there was evidence of inflammation and infection in the small pockets/pouches that had formed in the large intestine also known as diverticulitis. There was also presence of generalized (diffuse) peritonitis or infection of the lining of the inner abdominal wall and organs. Initial Damage Control procedures included Sigmoidectomy which is the removal of last section of the colon (large intestine); descending colon was left closed and rectal stump (area above the anus) was closed. Patient received +2L of fluids with electrolytes, mineral salts and sugar (crystalloids) and medication to elevate blood pressure (vasopressors). Open abdomen was managed with temporary coverage of Abthera which is a vacuum/Negative pressure wound dressing in conjunction with AbClo. The Abdomen was left open for damage control and serial surgical interventions and patient was then transferred to the ICU for care and management.
Primary Fascial Closure was conducted on day #3 after 1 take back to the OR. A consistent and gradual decrease in the wound gap was recorded. Fascial/wound defect reduction and maintenance was conducted with AbClo over the post-operative period. AbClo was placed at the bedside in the ICU; Fascia and Skin were undamaged throughout the use of AbClo. Only one AbClo was used throughout the entire treatment.
Learn more about another case study featuring a 45-year-old with a post-operative complication here.
Learn more about AbClo here.