Treatment for long-term poorly closed incisions af ter hepatobiliar y surger y

摘要

BACKGROUND: Effective measures are lacking to treat long-term  poorly  closed  incisions  after  hepatobiliary surgery, including chronic sinus tract and keloid. This study aimed to introduce the treatment experiences with the abdominal wall and costal margin complications after hepatobiliary surgery, and to investigate the method for prevention of this kind of complication. METHODS:We  retrospectively  studied  26  patients  with complications of abdominal wall and costal margin after hepatobiliary  surgery,  who  had  been  admitted  to  our hospital since 1998. The 26 patients were classiifed according to complications into 3 groups: chronic ulcer with costal chondritis (5 patients), single chronic ulcer (3), and keloid (18). According to the symptoms of patients, treatments given  included  focal  removal  regional  lfap  transfer restoration and focal removal dermatoplasty combined with glucocorticoid  injection,  anti-scar  medication,  external application of silicone gel iflm, and pressure therapy after surgery to inhibit recurrence. RESULTS:Satisfactory results were observed in the 26 patients after the treatments. Focal and regional ache and itching disappeared, and 2-3-year follow-up revealed no recurrence. CONCLUSIONS:Attention should be paid to patients with complications of abdominal wall and costal margin after hepatobiliary  surgery.  Combined  treatment  or  mainly operations produce satisfactory result.