Management of enteroatmospheric fistulae

Terzi C., EGELİ T., Canda A. E., Arslan N. C.

INTERNATIONAL WOUND JOURNAL, vol.11, pp.17-21, 2014 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 11
  • Publication Date: 2014
  • Doi Number: 10.1111/iwj.12288
  • Journal Name: INTERNATIONAL WOUND JOURNAL
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.17-21
  • Keywords: Enteroatmospheric fistula, Negative pressure wound therapy, Open abdomen, VACUUM-ASSISTED CLOSURE, TOPICAL NEGATIVE-PRESSURE, SMALL-BOWEL FISTULAS, OPEN ABDOMEN, ENTEROCUTANEOUS FISTULAS, INTESTINAL FISTULIZATION, PERITONITIS, TRAUMA, SYSTEM, WOUNDS
  • Dokuz Eylül University Affiliated: Yes

Abstract

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.