title: The parachute design as a new extraperitoneal method of closing a recalcitrant high-output enterocutaneous fistula: report of a case.
abstract: We introduce a new method for closure of a recalcitrant high-output jejunal enterocutaneous fistula. First, a transposed rectus abdominis muscle is sutured into the fistula opening using a parachuting technique, then the muscle is covered with a skin graft and temporarily immobilized to the fistula wall and abdominal wall with a negative pressure device. This extraperitoneal method provides tension-free closure of the fistula with well-vascularized tissue, without compromising the intestinal lumen. No bowel is resected. This new technique allows for early mobilization and recommencement of enteral nutrition.
authors.affiliation: Department of Plastic Surgery and Hand Surgery, University Hospital North Norway, 9038 Tromsø, Norway. louis.deweerd@unn.no
authors.forename: Louis
authors.initials: L
authors.lastname: de Weerd
authors.forename: Jørn
authors.initials: J
authors.lastname: Kjæve
authors.forename: Solveig
authors.initials: S
authors.lastname: Nergård
mesh_terms: D006801:Humans; D007412:Intestinal Fistula / Q000601:surgery*; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy; D017568:Rectus Abdominis / Q000601:surgery; D016038:Skin Transplantation; D013524:Surgical Flaps; D013536:Suture Techniques; D016896:Treatment Outcome