Negative Pressure Wound Therapy with Instillation as Conservative Management for a Large Abdominal Wound Following Incarcerated Parastomal Hernia Repair

Parastomal herniation is a common complication following stoma creation, necessitating surgical repair in up to one-quarter of cases, including emergency cases of incarceration or strangulation. Following hernia repair with or without mesh placement, surgical sites are at risk of infection post-operatively and this is typically resolved by removing the mesh, which can be technically challenging. Few studies have assessed conservative management options for these types of cases. Here, we present a case where negative pressure wound therapy (NPWT) with instillation was utilized for secondary intention healing of a large abdominal wound (20 cm x 23 cm x 5 cm) following mesh infection post-parastomal hernia repair. The patient’s wound was completely healed after eight weeks and she had no long-term complications at the one-year follow-up. NPWT with instillation is an option for the conservative management of large abdominal wounds, which can be considered on a case-by-case basis.