Postoperative abdominal wall defects with enterocutaneous fistulae.
BACKGROUND
Abdominal wall dehiscence with an associated enterocutaneous fistula is a surgical complication with high morbidity and mortality. Management of the abdominal wall defect is complicated by the continued emergence of liquid bowel contents.


METHODS
Large abdominal wall wounds of 10 patients with postoperative abdominal wall dehiscence and active enterocutaneous fistulae were managed with early skin grafting directly onto the granulated abdominal viscera.


RESULTS
Skin graft take averaged 93 +/- 12%, and there were no perioperative complications related to the skin grafting procedure. Overall mortality was 1 out of 10 patients. Enterocutaneous fistula output did not prove overly injurious to the skin grafts. Wound care was simplified in all but 1 patient with fitting of an ostomy appliance.


CONCLUSIONS
Temporary abdominal wall wound closure with skin grafts improved patient comfort and simplified wound care in a staged reconstructive approach to this surgical complication.
Dumanian
G A
GA
Division of Plastic Surgery, University of Pittsburgh, Pennsylvania, USA.
Llull
R
R
Ramasastry
S S
SS
Greco
R J
RJ
Lotze
M T
MT
Edington
H
H
D000007:Abdominal Injuries / Q000601:surgery; D000008:Abdominal Neoplasms / Q000601:surgery; D017577:Cutaneous Fistula / Q000209:etiology*; D003646:Debridement / Q000009:adverse effects; D005500:Follow-Up Studies; D006801:Humans; D007813:Laparotomy / Q000009:adverse effects*; D008080:Liposarcoma / Q000601:surgery; D016031:Liver Transplantation; D010030:Ostomy; D010195:Pancreatitis / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D016038:Skin Transplantation; D013529:Surgical Wound Dehiscence / Q000209:etiology*