case_images: PMC10680577_01
case_images: Abdominal computed tomography scans of a 66-year-old woman who had been diagnosed with incisional hernia 4 years previously but was not treated. The scans showed an incisional hernia of the small bowel contents with subcutaneous fluid and gas collection. While a prolapsed small bowel due to an incisional hernia can become necrotic, small bowel obstruction was not observed in this case.
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case_images: The hernia defect measured 6 cm (length) x 3.8 cm (width) (Figure 1).
case_images: Emergency radical surgery was performed on a 66-year-old woman for life-threatening incisional hernia. (A) Her abdomen showed severe distention, erythema with sharp margins, swelling, bullae, and necrotic skin and dishwater-gray exudate around the operative scar. (B) The injured areas of the skin, soft tissue, and hernia contents of the small bowel were resected en bloc. An intact small bowel was thus clearly revealed (black arrowhead). (C) Hand sewn anastomosis of the small bowel was performed (black arrowhead). (D) The wound defect of the skin and subcutaneous tissue was treated with negative pressure wound therapy.
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case_images: The injured wound defect of the skin and subcutaneous tissue was treated with NPWT (Figure 2).
case_images: Negative pressure wound therapy was carried out for 4 weeks after emergency radical surgery on a 66-year-old woman for life-threatening incisional hernia. Conservative management of the wound was successful without skin grafting or any other surgical management. (A) One month after surgery. (B) Two months after surgery. (C) Five months after surgery.
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case_images: Negative pressure wound therapy was performed for 4 weeks postoperatively, and conservative wound management was successful (Figure 3).