Wound, Soft Tissue And Reconstructive Complications After Kidney Transplantation
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.
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