Chronic Pelvic Abscedation After Completion Proctectomy in a Rectal Stump Insufficiency; Treatment With Gracilis Muscle Flap Following Vacuum Assisted Closure Therapy.
- Author:
Fatma Ayca GULTEKIN
1
;
Bekir Hakan BAKKAL
;
Sait TAYFUN
;
Orhan BABUCCU
;
Mustafa COMERT
Author Information
- Publication Type:Case Report
- Keywords: Rectal; Stump; Insufficiency; Negative-pressure Wound therapy; Pedicled flap
- MeSH: Abscess; Debridement; Muscles; Negative-Pressure Wound Therapy; Surgical Flaps; Vacuum; Wound Healing
- From:Annals of Coloproctology 2013;29(4):172-176
- CountryRepublic of Korea
- Language:English
- Abstract: Presacral abscess formation due to rectal stump insufficiency following Hartmann procedure is very rare complication. If the abscess cavity is large, it might delay the reversal of the stoma and will probably result in a devastating future functioning of the neorectum. Moreover, very invasive treatments will be required in order to prevent severe septic complications. We present the case of a 58-year-old man with a past history of Hartmann procedure for a low rectal carcinoma who presented with rectal stump insufficiency and a large presacral abscess. Following extensive debridement and rectal stump resection, a vacuum-assisted closure (VAC) system was applied to the large abscess cavity to facilitate gracilis muscle flap reconstruction and to optimize wound healing. The satisfactory results showed in the present report led us to favor a combination of VAC therapy and a gracilis muscle flap in intrapelvic and perineal reconstruction in the case of large defects associated with high risks of septic complications.
