Treatment of Abdominal Surgical Wound Dehiscence With Bowel Exposure and Infection: Using Intrawound Continuous Negative Pressure, Irrigation, and Application of Artificial Dermis

: Abdominal surgical wound dehiscence with bowel exposure and infection carries a risk of intestinal fistula, making it extremely difficult to treat. The objective at this time is to heal such wounds safely and absolutely with using intrawound continuous negative pressure and irrigation treatment and artificial dermis. The subjects were 18 patients with abdominal wall dehiscence wounds with bowel exposure. Complications had already developed in 4 of the 18 cases of intestinal fistula. Subsequently, these 4 cases were treated with conservative treatment alone, whereas the other 14 were treated by split-thickness skin grafts. Intrawound continuous negative-pressure therapy has enabled the concomitant use of an artificial dermis inside the infected wound by maintaining irrigation of the wound. This method not only eliminated the danger of perforation from direct contact of the sponge with the bowel but also promoted the early proliferation of dermis-like tissue on the bowel surface, enabling safe and absolute healing.