Damage Control Surgery for Severe Abdominal Sepsis With Free Skin Graft Transplantation: A Case Report

Acute abdomen represents a great surgical challenge. Damage control surgery has been a better approach in acute abdominal emergencies to reduce the risk of mortality compared with primary definitive surgery.

A 52-year-old man presented with nonspecific abdominal pain for 2 days. Physical examination and computed tomography scan suggested abdominal viscera perforation and acute diffuse peritonitis. Segmental resections and sigmoidostomy were performed, the abdomen was temporarily closed with a 3-liter infusion bag and maintained for 72 hours. Small intestinal ischemic necrosis was found, partial resection of small intestine was performed later, and abdomen was still closed with the 3-liter infusion bag and maintained for 10 days. One month later, intermediate split thickness self-free skin graft transplantation was performed. Abdomen was closed 6 months later.

Damage control surgery with free skin graft transplantation can be successfully applied in severe abdominal infection in patients with an open abdomen. The study was in compliance with the Helsinki Congress and the Declaration of Istanbul.

Damage control surgery has been a better approach in acute abdominal emergencies to reduce the risk of mortality compared with definitive surgery. Although laparostomy is a useful treatment of abdominal sepsis, successful management with free skin graft transplantation after laparostomy has rarely been reported in stercoral perforation. We report a patient with severe abdominal sepsis treated with damage control surgery with free skin graft transplantation. The patient was discharged with good recovery.