(CS-118) Complicated Colorectal Wounds: Case Series of Patients Treated with Transforming Powder Dressing

Colorectal surgical wounds can be some of the most challenging wounds to manage, considering surgical site infection (SSI) ranges from 5-30% and is a costly complication, linked to significant increases in postoperative morbidity.¹ While leaving these wounds open may be effective in reducing SSI risk, these techniques have disadvantages for patients including pain with frequently needed dressing changes and potential need for wound closure at a later date.¹

Methods:

We present 4 colorectal surgical patients who were treated with transforming powder dressing (TPD) initially or after failing standard of care (SOC). TPD is a commercially available dressing that forms a moist, oxygen-permeable barrier that covers and protects the wound.

1.  55 y/o with recurrent colon cancer s/p SBR with resultant 60.75 cm³ abdominal wound with 9 cm tunnel. Wound vac applied while hospitalized but no coverage for wound vac/home health on discharge. Discharged home with daily gauze dressing performed by wife.


2. 62 y/o with metastatic ovarian cancer underwent rectosigmoid resection/colostomy and developed mucocutaneous separation (MCS); no treatment prior to TPD.


3. 48 y/o s/p transverse colostomy/partial colectomy/Stamm Gastrostomy developed enterocutaneous and enteroatmospheric fistulas, and 2159.4 cm³  abdominal wound. Failed wound vac (drainage obstructing machine).


4. 41 y/o with rectal cancer s/p robotic low anterior resection with diverting loop ileostomy c/b abdominal wound dehiscence (750 cm³ wound with 10 cm tunnel) and treated with wound vac but discontinued due to pain and fistula development. 

Patient #2 started on weekly application of TPD as initial treatment. All other wounds were converted to weekly applications of TPD. No complications with TPD application observed.

1. Tunnel (9 cm) healed in 6 weeks.  Wound was 2 cm³  (97% healed) after 18 weeks* while on chemotherapy.


2. MCS healed in 6 weeks.


3. Wound healed in 30 weeks.


4. Wound was 0.4cm³  (99% healed) after 29 weeks.*

 *time of abstract submission

Discussion:

All surgical wounds healed or were nearly healed without complications at time of submission. Overall nursing time and dressing change frequency were reduced using TPD compared to SOC. TPD may provide a safe, efficient and less painful solution for the management of postoperative colorectal wounds.