Wound, Soft Tissue and Reconstructive Complıcatıons After Kidney Transplantation
Özet
Wound-related, soft tissue, and reconstructive complications remain important causes of morbidity after kidney transplantation despite advances in surgical technique, perioperative care, and immunosuppressive therapy. Common complications include surgical site infection, hematoma, seroma, lymphocele, wound dehiscence, skin necrosis, and incisional hernia. Renal transplant recipients are particularly vulnerable because diabetes mellitus, obesity, malnutrition, vascular disease, and chronic immunosuppression may impair wound healing. Early recognition is essential, as delayed diagnosis may lead to deep infection, graft dysfunction, prolonged hospitalization, repeated operations, or complex abdominal wall defects. Clinical evaluation should be supported by laboratory studies and imaging, with ultrasonography serving as the first-line modality for perigraft collections. Management ranges from conservative wound care and targeted antimicrobial therapy to drainage procedures, operative debridement, fascial repair, and reconstructive surgery. Reconstructive options include delayed closure, skin grafting, local or regional flaps, mesh reinforcement, and abdominal wall reconstruction in selected cases. Negative pressure wound therapy is a useful adjunct in both treatment and staged reconstruction. Optimal outcomes depend on timely intervention and a multidisciplinary approach involving transplant surgeons, nephrologists, infectious disease specialists, radiologists, and reconstructive surgeons.
Referanslar
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