Wound exudate reduction from retroperitoneum with facilitation of healing by triamcinolone injection: A case report

Rationale: Maintaining a moderately moist environment is important in the treatment of chronic skin ulcers. Excessive exudate inhibits wound healing, although it may be difficult to control. We report a case of successful treatment with triamcinolone to suppress retroperitoneal exudates and facilitate wound healing. Patient concerns: A 78-year-old man presented to our department with excessive exudative oozing from a chronic ulcer in the gluteal region. The retroperitoneum was exposed for a prolonged period after colon cancer surgery and developed chronic granulation. Diagnoses: The exposed retroperitoneum was covered using an island flap, with the left superior gluteal artery perforator providing the feeding vessels and skin graft, which covered part of the flap harvesting area. The flap and lower bed did not adhere because of the presence of an excessive retroperitoneal exudate. Skin grafts to the flap harvesting area were not accepted, and secondary healing did not proceed because of exudate leakage. Intervention: A single dose of 2.5-mg triamcinolone was injected inferiorly to the flap. Outcomes: After injection of triamcinolone, the exudate decreased, and secondary healing in the residual ulcer progressed satisfactorily. Conclusion: Injection of triamcinolone might be an option for controlling exudates to heal skin ulcers.