Perioperative management of postoperative sigmoid colon cancer complicated by a large abdominal wall defect: A case...

Large abdominal wall defect (LAWD) measures > 20 cm in width. LAWD can easily lead to intestinal necrosis, peritonitis, other complications, and even multiple organ dysfunction syndrome. Multiple intestinal fistulas are high-flow fistulas that can cause severe water-electrolyte imbalance and malnutrition, as well as inflammation, high metabolic status, and chronic intestinal failure caused by intestinal fluid corrosion in tissues around the orifice fistulas.

This article summarizes the nursing experience of a patient with sigmoid carcinoma who has LAWD with multiple intestinal fistula due to repeated operations for postoperative complications. The key points of care: Scientific assessment of nutritional status, dynamic adjustment of nutritional support programmes, comprehensive adoption of enteral nutrition, parenteral nutrition and combined nutrition of enteral and parenteral; taking good care of abdominal wall defects and intestinal fistulas; continuous flushing of the abdominal drainage tube and low negative pressure drainage; prevention of venous thrombosis; strengthening of physical exercise; implementation of positive psychological interventions.

After more than 7 months of careful care, the patient's physical fitness has been well recovered, local inflammation is well controlled, which wins the opportunity for the operation, and the postoperative recovery is good.