ePlasty: Vol. 16
Munchausen Syndrome Disguised As Gossypiboma: An Interesting Case
Andrea Little, MD, MBA, Heather Curtis, MD, Brian Kellogg, MD and Michael Harrington, MD, MPH

Department of Plastic Surgery, University of South Florida Morsani College of Medicine, Tampa; and H. Lee Moffitt Cancer Center, Tampa, Fla


Correspondence: hcurtis1@health.usf.edu
Keywords: gossypiboma, surgical foreign body, Munchausen syndrome, factitious disorder, self-injurious behavior

DESCRIPTION

A 45-year-old woman presented with recurrent cellulitis of a chronic right medial thigh wound at the site of a previous gracilis flap reconstruction (Fig 1). The donor site dehisced postoperatively and persisted despite numerous debridements, delayed primary closures, antibiotic regimens, and wound care. At the time of irrigation and debridement (Fig 2), several 2- to 3-cm fragments of gauze were removed from deep within the wound (Fig 3). Delayed primary closure was performed after subsequent debridements demonstrated no residual foreign body or infection. Two weeks later, the patient again presented with wound infection (Fig 4). Two fragments of gauze were encountered immediately under the surface of the incision during bedside irrigation & debridement (I&D). Subsequent management involved opening the wound, copious irrigation, removal of additional gauze, and vacuum assisted closure placement to prevent the patient from accessing her wound. A psychiatry consult .......