清创联合负压封闭引流治疗因腹壁包埋异体脐带行免疫治疗导致的腹壁严重感染

Debridement combined with vacuum sealing drainage in the treatment of severe infection in abdomi- nal wall due to allogeneic umbilical cord embedded in abdominal wall for immunotherapy

目的探讨应用清创联合负压封闭引流（VSD）治疗因腹壁包埋异体脐带行免疫治疗导致的腹壁严重感染的效果。方法2015年1月—2016年12月，笔者单位收治12例因腹壁包埋异体脐带行免疫治疗导致腹壁严重感染的患者。采用全身抗感染、局部彻底清创联合VSD治疗。创面安装VSD装置后连续冲洗3～5 d，负压值为－16.0～－12.0 kPa，5～7 d后去除VSD装置，继续用无菌纱条填塞无效腔换药，无效腔内肉芽组织生长良好后关闭切口。结果12例患者的异体脐带被完全取出，腹壁感染均得以治愈。创面愈合良好，腹壁感觉正常，活动未受限。术后随访3～6个月，无再次感染或切口疝发生。结论将整段异体脐带进行腹壁包埋用于免疫治疗可导致腹壁严重感染。清创联合VSD治疗可治疗该类腹壁感染，获得良好的临床效果。

ObjectiveTo explore the effect of debridement combined with vacuum sealing drainage （VSD） on the treatment of severe infection in abdominal wall due to allogeneic umbilical cord embedded in abdominal wall for immunotherapy.MethodsFrom January 2015 to December 2016, 12 patients with severe infection in abdominal wall due to allogeneic umbilical cord embedded in abdominal wall for immunotherapy were admitted to our department. They were conducted with systemic anti-infective treatment, local debridement, and VSD. The wounds were continuously washed for 3 to 5 days after the VSD device installed, with negative pressure value from -16.0 to -12.0 kPa. The VSD device was removed 5 to 7 days later. Continue wound dressing by aseptic ribbon gauze was stuffed in the cavity, and the incision was sutured after the granulation tissue grew well in the cavity.ResultsIn all patients, allogeneic umbilical cords were completely removed and abdominal infection was cured. The wounds healed well, the sensory function of abdominal was normal, and the activity was not restricted. All the patients were followed up for 3 to 6 months with no reinfection or incisional hernia.ConclusionsEmbeding the whole allogeneic umbilical cord in abdominal wall for immunotherapy can lead to severe infection in abdominal wall. Abdominal infection can be cured by debridement combined with VSD with good clinical results.