UrgoTul® Ag/Silver dressing as an intermediate layer in negative pressure wound therapy in patient with unhealing wound after laparotomies

Treating of postoperative complications in patients after numerous laparotomies is difficult. In the case of dehiscence of the surgical wound, the infection and the co-existing formation of intestinal fistulas, the treatment requires a multidisciplinary approach. In these cases vacuum assisted therapy is very useful. However, it is necessary to remember about the protection of the intestines or fistula and surrounding tissues against the action of polyurethane foam – protect the intestines and skin against ingrowing into a black foam.

Male patient, 54 years old, after numerous laparotomies was admitted to our clinic to treat complications after left-sided nephrectomy. The patient developed intestinal and enterocutaneous fistulas. There was wound dehiscence and necrosis of surrounding tissues. The negative pressure wound therapy was applied. The change of dressing was three times. The correction of the stomy was performed. Each time between the wound and the polyurethane foam, UrgoTul® Ag/Silver was used as a protective intermediate layer. The use of UrgoTul® Ag/Silver in our patient (with the infection, the dehiscence of the wound, and with the enterocutaneous fistula) showed a significant decrease in the secretion of the intestinal fistula. Healing and closure of the surgical wound, its epithelialization and elimination of inflammation of the abdominal wall was observed.