"Fistula patch": making the treatment of enteroatmospheric fistulae in the open abdomen easier

Gefei Wang, Jianan Ren, Song Liu, Xiuwen Wu, Guosheng Gu, Jieshou Li
Journal of Trauma and Acute Care Surgery 2013, 74 (4): 1175-7

BACKGROUND: It remains an extreme challenge in clinical practice to manage the enteroatmospheric fistula (EAF), which is a severer complication after abdominal opening. In current literature, several methods have been established, generally focusing on controlling fistula effluent and keeping the wound bed clean. However, the loss of enteric fistula effluent would potentially lead to a risk of the disturbance of internal environment and malnutrition.

METHODS: We designed an innovative "fistula patch" technique for protecting open abdominal wounds from being contaminated by intestinal fistulae drainages and simultaneously applying enteral nutrition.

RESULTS: Eleven patients with single EAF were treated with fistula patch technique. Enteral nutrition was then administrated successfully until the definite surgery.

CONCLUSION: The fistula patch technique is a simple, effective, and inspiring method to control EAF, as it brings together the benefits of avoiding the loss of enteric fistula effluent, simplifying wound management, ceasing tissue destruction, and providing enteral nutrition application.

LEVEL OF EVIDENCE: Therapeutic/care management, level V.

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