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.