- 期刊
術後傷口癒合不良之中醫會診病例報告
Chinese medicine consultation for poor surgical wound healing: a case report
摘要
75歲女性，有卵巢癌切除病史。因癌症轉移，入院切除右側結腸，術後第三天因腹膜炎、腹壁壞死，接受筋膜切除、迴腸造口術，且傷口培養發現綠膿桿菌、腸桿菌，接受抗生素治療，三周後因手術傷口癒合不良會診中醫。會診時，傷口周圍的皮膚和造口的黏膜色紅且傷口偶有黃綠色分泌物，腹腔引流色濁，大便溏薄、食量少、血色素低、肢體倦怠，辨證為脾氣虛夾濕熱。以參苓白朮散合托里消毒飲為主方，健脾益氣、滲濕止瀉、排膿解毒。服科中一周見傷口周圍膚紅減、滲出液減，且腸胃症狀減緩，再隨症加減用藥兩周，傷口癒合良好出院，並帶藥兩周，兩周後回傳照片見癒合更佳。在此案例我們發現中醫藥介入有助改善術後傷口癒合不良。
並列摘要
This is a 75-year-old female with a history of ovarian cancer resection. Due to cancer metastasis, she underwent right-sided colectomy, and on the third postoperative day, she developed peritonitis and necrosis of the abdominal wall. She underwent fascial excision and ileostomy due to the conditions mentioned. Wound culture revealed Pseudomonas aeruginosa and Escherichia coli, and she received antibiotic treatment. Three weeks later, due to poor surgical wound healing, she was consulted with traditional Chinese medicine (TCM). During the consultation, the skin around the wound and the mucosa of the ileostomy showed redness, occasional yellow-green discharge from the wound, cloudy drainage from the abdominal cavity, loose stools, poor appetite, low hemoglobin levels, and fatigue. The TCM diagnosis was spleen qi deficiency with damp-heat accumulation. The main treatment principle was based on Shenling Baizhu San combined with Tolix Disinfectant Decoction, aimed at tonifying spleen and qi, resolving dampness and diarrhea, and promoting pus drainage and detoxification. After one week of TCM treatment, there was reduction in redness and exudate around the wound, as well as improvement in gastrointestinal symptoms. Medication was adjusted according to symptoms for another two weeks. The wound healed well and the patient was discharged with medications for an additional two weeks. Follow-up photos two weeks later showed further improvement in healing. In this case, we found that TCM intervention helped improve poor postoperative wound healing.