title: Staged management of the open abdomen and enteroatmospheric fistulae using split-thickness skin grafts.
abstract: BACKGROUND
  Management of the open abdomen with polyglactin 910 mesh followed by split-thickness skin grafts allows safe, early closure of abdominal wounds. This technique can be modified to manage enteroatmospheric fistulae. Staged ventral hernia is performed in a less inflamed surgical field.
  
  
  METHODS
  A retrospective review was performed of 59 consecutive patients who underwent abdominal skin grafting for open abdominal wounds from 2001 to 2011.
  
  
  RESULTS
  The median length of follow-up was 215 days. Thirty-one percent of patients presented with preexisting enteroatmospheric fistulae, and 41% required polyglactin 910 mesh placement before skin grafting. Partial or complete skin graft failure occurred in 7 patients. Four patients required repeat skin grafting. All patients ultimately achieved abdominal wound closure, and none developed de novo fistulae.
  
  
  CONCLUSIONS
  With proper technique, skin grafting of the open abdomen with a planned ventral hernia repair is a safe and effective alternative to delayed primary closure.
authors: Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, 675 N St Clair, Suite 19-250, Chicago, IL 60611, USA.
authors: Jennifer E
authors: JE
authors: Cheesborough
authors: Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, 675 N St Clair, Suite 19-250, Chicago, IL 60611, USA.
authors: Eugene
authors: E
authors: Park
authors: Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, 675 N St Clair, Suite 19-250, Chicago, IL 60611, USA.
authors: Jason M
authors: JM
authors: Souza
authors: Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, 675 N St Clair, Suite 19-250, Chicago, IL 60611, USA. Electronic address: dumanian1@gmail.com.
authors: Gregory A
authors: GA
authors: Dumanian
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007412:Intestinal Fistula / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods*; D013526:Surgical Mesh; D013529:Surgical Wound Dehiscence / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Abdominal wall reconstruction; Enteroatmospheric fistula; Enterocutaneous fistula; Open abdomen; Skin graft