title: Use of a silver dressing for management of an open abdominal wound complicated by an enterocutaneous fistula-from hospital to community.
abstract: BACKGROUND
  Management of an open abdominal wound complicated by an enterocutaneous fistula poses multiple challenges. The enterocutaneous fistula we discuss opened directly into the abdominal wound, without forming a track through skin.
  
  
  METHODS
  We discuss a patient who underwent a Hartmann's procedure for diverticulitis, followed by repeat laparotomies for washout. Due to the edematous bowel and ongoing sepsis, it was not possible to close the abdomen by primary closure. Negative pressure wound therapy (NPWT) has been used successfully in these circumstances. However, the position of an enterocutaneous fistula prevented application of NPWT, and a more conservative approach was used to reduce infection and enable wound closure by secondary intention.
  
  
  CONCLUSIONS
  Owing to the presence of an enterocutaneous fistula, we applied a silver-based dressing as an alternative to NPWT. The silver-based dressing was initially applied during the patient's hospital course and continued into the community, ultimately resulting in closure of the wound and fistula.
authors.affiliation: Queen Elizabeth Hospital, Woolwich, London, the United Kingdom.
authors.forename: Chanpreet
authors.initials: C
authors.lastname: Arhi
authors.forename: Ahmed
authors.initials: A
authors.lastname: El-Gaddal
mesh_terms: D000007:Abdominal Injuries / Q000628:therapy*; D058107:Abdominal Wound Closure Techniques; D000328:Adult; D001458:Bandages; D005260:Female; D006097:Granulation Tissue; D006801:Humans; D007412:Intestinal Fistula; D007813:Laparotomy; D011091:Polyesters / Q000008:administration & dosage* / Q000627:therapeutic use; D011095:Polyethylenes / Q000008:administration & dosage* / Q000627:therapeutic use; D014945:Wound Healing
chemical_list: C117408:Acticoat; D011091:Polyesters; D011095:Polyethylenes