title: Treatment of small-bowel fistulae in the open abdomen with topical negative-pressure therapy.
abstract: BACKGROUND
  An open abdomen (OA) can result from surgical management of trauma, severe peritonitis, abdominal compartment syndrome, and other abdominal emergencies. Enteroatmospheric fistulae (EAF) occur in 25% of patients with an OA and are associated with high mortality.
  
  
  METHODS
  We report our experience with topical negative pressure (TNP) therapy in the management of EAF in an OA using the VAC (vacuum asisted closure) device (KCI Medical, San Antonio, TX). Nine patients with 17 EAF in an OA were treated with topical TNP therapy from January 2006 to January 2009. Surgery with enterectomy and abdominal closure was planned 6 to 10 weeks later.
  
  
  RESULTS
  Three EAF closed spontaneously. The median time from the onset of fistulization to elective surgical management was 51 days. No additional fistulae occurred during VAC therapy. One patient with a short bowel died as a result of persistent leakage after surgery.
  
  
  CONCLUSIONS
  Although previously considered a contraindication to TNP therapy, EAF can be managed successfully with TNP therapy. Surgical closure of EAFs is possible after several weeks.
authors: Department of Digestive Surgery, Groeninge Hospital, Belgium. mathieudhondt2000@yahoo.com
authors: Mathieu
authors: M
authors: D'Hondt
authors: Dirk
authors: D
authors: Devriendt
authors: Frank
authors: F
authors: Van Rooy
authors: Franky
authors: F
authors: Vansteenkiste
authors: André
authors: A
authors: D'Hoore
authors: Freddy
authors: F
authors: Penninckx
authors: Marc
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