title: Clinical evaluation of a temporary fecal containment device for non-surgical fecal diversion in perineal burns.
abstract: BACKGROUND
  The aim of this study was to evaluate the clinical results of a temporary fecal containment device (Flexi-Seal® FMS) in our burn center.
  
  
  METHODS
  All patients in whom temporary fecal containment devices were applied for perineal burns between August 2008 and August 2009 in our institution were reviewed. Demographics, etiology of burns, total body surface area (TBSA) burned, intensive care unit (ICU) need, early mortality, and post-application data were obtained from a prospectively designed database. In addition, some variables were investigated as potential risks factors for fecal leakage.
  
  
  RESULTS
  The mean age of patients (n=15) was 43.1±22.1 years, and 66.7% of the patients were male. The mean %TBSA burned was 40.7±16.6. Fecal leakage was seen in 6 patients. Local infection in the perineum was observed in 6 patients, including 4 of the 6 patients with fecal leakage. The mortality rate was 33% (5 deaths). All exitus patients had 50% or more TBSA burned. Electrical burn injury was found as a significant risk factor for fecal leakage in surviving patients (p<0.05). Autologous split-thickness grafting was performed in 8 patients without complication. The mean duration of catheterization was 22.5±5.7 days. Except for superficial mucosal erosion in the distal rectum in 2 cases, no complication was observed. The mean hospitalization time was 46.7±12.7 days.
  
  
  CONCLUSIONS
  If the safety of these devices is proven in further prospective, high-volume studies, they may reduce the necessity of diverting stoma operation in burn patients.
authors.affiliation: Department of General Surgery, Kartal Education and Research Hospital, İstanbul, Turkey. mkement@mailcity.com
authors.forename: Metin
authors.initials: M
authors.lastname: Kement
authors.forename: Hakan Ahmet
authors.initials: HA
authors.lastname: Acar
authors.forename: Ilhami Soykan
authors.initials: IS
authors.lastname: Barlas
authors.forename: Nihat
authors.initials: N
authors.lastname: Aksakal
authors.forename: Cem
authors.initials: C
authors.lastname: Gezen
authors.forename: Uygar
authors.initials: U
authors.lastname: Düzci
authors.forename: Mustafa
authors.initials: M
authors.lastname: Oncel
mesh_terms: D000328:Adult; D000368:Aged; D001830:Body Surface Area; D002056:Burns / Q000150:complications / Q000473:pathology / Q000628:therapy*; D002058:Burns, Electric / Q000150:complications / Q000628:therapy; D002404:Catheterization / Q000295:instrumentation; D005242:Fecal Incontinence / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010502:Perineum / Q000293:injuries*; D012189:Retrospective Studies; D012307:Risk Factors; D012449:Safety; D012874:Skin Diseases, Infectious / Q000517:prevention & control; D016038:Skin Transplantation / Q000592:standards; D013997:Time Factors; D014182:Transplantation, Autologous; D055815:Young Adult