Authors (including presenting author) :
Shit, KYF(1), Wong, HY (2), Tsui SYB (2), Chan KWE (2), Mak HN (1), Tong SY(1), Lam MY (1), Cheung KWA (1), Yu HY (1), Leung YY (1), Wong YK (1), Lee LN (1)
Affiliation :
(1) NTEC Wound Services Team / Department of Surgery, Prince of Wales Hospital
(2) Hong Kong Children Hospital / Prince of Wales Hospital
Introduction :
Woundoscopy is an innovative technology designed for wound assessment that enhances visualization of wound bed. In this case report, a 14 year-old boy was fashioned with loop colostomy due to accidental rectal injury, later closure of stoma was performed. However, ex-stoma site was suspected with gas leaking and required urgent paediatric surgical attention. Patient and parent resisted to go through another invasive diagnostic surgery again. Therefore, Paediatric surgeons and NTEC Wound Services Team collaborated to excel wound exploration and management using woundoscopy and home negative pressure wound therapy (NPWT) to promote wound healing and early discharge.
Objectives :
(1) To provide early information on the origin of air leak in the abdominal wound without traditional invasive surgical intervention.
(2) To promote wound healing by appropriate wound care regime based on woundoscopy findings.
Methodology :
The patient underwent the first bedside woundoscopy performed after air leak from wound being suspected. One 1mm defect was observed in wound bed. Silver-impregnated hydrofiber packing to wound was recommended by Wound Team afterwards. After 9 days, the second session of woundoscopy was done, no faecal matter nor definite bubble seen. Low-pressure NPWT (100 mmHg) was applied based on the findings of wound bed integrity. Home NPWT was further supported after discharge, with out-patient follow up for continuous monitoring wound condition.
Result & Outcome :
The wound size was decreased by 90% after 4 weeks of wound care by silver-impregnated dressing and NPWT. No further air bubble was noted from wound bed. The patient did not need to receive any invasive surgical intervention throughout the wound healing process. The patient and parent were well informed and reassured about the wound condition based on woundoscopy findings and complied with all wound care regimes. The patient was able to resume school with home NPWT. After all, joint team collaboration was deemed successful on meticulous complicated wound management with precise evaluation of wound status by endoscopic approach.
