Treatment for long-term poorly closed incisions after hepatobiliary surgery.
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 classified 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 flap transfer restoration and focal removal dermatoplasty combined with glucocorticoid injection, anti-scar medication, external application of silicone gel film, 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.
Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.
Jing-De
JD
Zhang
Shou-Jie
SJ
Wang
Chuan
C
Lv
Xin
X
Xing
D034861:Abdominal Wall; D000287:Administration, Topical; D000328:Adult; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects*; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020034:Silicone Gels / Q000008:administration & dosage*; D016038:Skin Transplantation / Q000379:methods*; D013529:Surgical Wound Dehiscence / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing
D005938:Glucocorticoids; D020034:Silicone Gels