Vacuum-assisted closure for cutaneous gastrointestinal fistula management.
BACKGROUND
Cutaneous gastrointestinal (GI) fistulas are a challenging complication in the oncologic patient population. The fistulous effluent is difficult to manage and adversely alters quality of life. Nonsurgical management of enteric fistulas is successful in 30% of cases, requiring at least 4 to 6 weeks. Recently a new technology has been developed to expedite wound healing. The Vacuum-Assisted Closure (VAC) method is a subatmospheric pressure technique that has been demonstrated in laboratory and clinical studies to significantly improve wound healing. Here we report its use in the successful medical management of a cutaneous GI fistula.


METHODS
A 63-year-old woman with advanced ovarian cancer developed an extensive complex cutaneous GI fistula in an open healing wound. She was treated with total parental nutrition and the VAC device, which resulted in complete closure of the fistula.


CONCLUSIONS
We propose that the VAC device may be a useful adjunct for the medical management of cutaneous GI fistulas.
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina 27710, USA.
A A
AA
Alvarez
G L
GL
Maxwell
G C
GC
Rodriguez
D017577:Cutaneous Fistula / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology / Q000601:surgery*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000150:complications*; D013514:Surgical Procedures, Operative / Q000379:methods; D014618:Vacuum