Management of enteroatmospheric fistulae.
A small-bowel enteroatmospheric fistula (EAF) is an especially challenging complication for patients with open abdomens (OAs) and their surgeons. Manipulation of the bowel during treatment (e.g. dressing changes) is one of the risk factors for developing these openings between the atmosphere and the gastrointestinal tract. Unlike enterocutaneous fistulae, EAFs have neither overlying soft tissue nor a real fistula tract, which reduces the likelihood of their spontaneous closure. Surgical closure is necessary but not always easy to do in the OA environment. Negative pressure wound therapy (NPWT) has been used successfully as an adjunct therapy to heal the wound around EAFs. This review discusses many aspects of managing EAFs in patients with OAs, and presents techniques that have been developed to isolate the fistula and divert effluent while applying NPWT to the surrounding wound bed.
Department of Surgery, Dokuz Eylul University Hospital, Izmir, Turkey.
Cem
C
Terzi
Tufan
T
Egeli
Aras E
AE
Canda
Naciye C
NC
Arslan
D000005:Abdomen / Q000601:surgery*; D058107:Abdominal Wound Closure Techniques; D006801:Humans; D007412:Intestinal Fistula / Q000150:complications*; D054843:Negative-Pressure Wound Therapy; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D013529:Surgical Wound Dehiscence / Q000209:etiology* / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000209:etiology* / Q000517:prevention & control*; D016896:Treatment Outcome; D014945:Wound Healing
Enteroatmospheric fistula; Negative pressure wound therapy; Open abdomen