A simple novel technique for enteroatmospheric fistulae: silicone fistula plug

Özer, Mustafa; Sinan, Hüseyin; Zeybek, Nazif; Peker, Yusuf

doi:10.1111/iwj.12308

Cited by 21 publications

(18 citation statements)

References 7 publications

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“…Isolation of the gastrointestinal contents is one of the most important factors for preventing the spread of infections and for promoting wound healing. It has been demonstrated that NPWT under low intestinal pressure is effective for the management of fistulas [6, 7, 13]. In our patient, total parenteral nutrition was utilized to decrease the enteral pressure as well as the intestinal fluid secretion and to reduce the contamination of the wound and abdominal cavity with intestinal fluids.…”

Section: Discussionmentioning

confidence: 92%

Complete abdominal wound and anastomotic leak with diffuse peritonitis closure achieved by an abdominal vacuum sealing drainage in a critical ill patient: a case report

et al. 2018

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BackgroundNegative pressure wound therapy (NPWT) is a widely accepted technique to treat local infectious wounds of the skin, subcutaneous tissue, fascia, or muscle. Recently, several reports describing the efficacy of NPWT for various types of fistulas and anastomotic leaks have been published. We herein describe a patient with an open abdominal wound due to colonic anastomotic leakage and diffuse peritonitis, in whom abdominal vacuum sealing (AVS) as a modified NPWT was useful for the management of this complex wound.Case presentationA 32-year-old man was admitted to our hospital with late presenting traumatic diaphragmatic hernia and strangulated ileum complicated by necrosis of the ileum and transverse colon. He had a history of cervical spinal cord injury due to suicide attempt 14 years earlier and, as a result of cervical spinal cord injury, he was paralyzed in the lower body. The patient underwent an urgent hernia repair and bowel resection. Postoperatively, he developed severe septic shock. On postoperative day (POD) 6, wound dehiscence due to colonic anastomotic leakage with diffuse peritonitis was diagnosed, but he was unable to undergo re-operation because of refractory severe septic shock combined with neurogenic shock due to the cervical cord injury. The patient was treated with AVS therapy. He gradually recovered from septic shock, and the anastomotic leakage healed after a 2-month period. The wound dehiscence was also reduced. The patient resumed oral intake on POD 112 and was discharged on POD 190.ConclusionsAlthough surgical repair would be the best method for the treatment of diffuse peritonitis due to gastrointestinal perforation or anastomotic leakage, our case suggests that AVS with ‘conventional’ drainage is a treatment of choice for open abdominal wounds even in the presence of diffuse peritonitis caused by intestinal anastomotic leakage, especially in patients with poor general medical condition.

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Section: Discussionmentioning

confidence: 92%

Complete abdominal wound and anastomotic leak with diffuse peritonitis closure achieved by an abdominal vacuum sealing drainage in a critical ill patient: a case report

et al. 2018

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“…Ramsay and Galo attempted to transform EAF into enterocutaneous fistula through a Foley catheter put into the fistula, which was taken out through a tunnel in the healthy tissues of the abdominal wall (33). Recently, Ozer et al, reported a successful closure in 1 patient by using of a novel "silicone fistula plug" technique (30). They used a circular silicone plug inserted in the fistula, which was suspended for an aluminium bridge over the abdominal wall.…”

Section: Discussionmentioning

confidence: 99%

Enteroatmospheric fistulas - the challenge of the open abdomen

Mutafchiyski

Popivanov

Kjossev

et al. 2015

SSM

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INTRODUCTION:In the past two decades, the open abdomen (OA) technique has gained wide popularity as an effective approach in the cases with severe peritonitis, abdominal compartment syndrome and critical trauma. However, it is still associated with high complication rate. Enteroatmospheric fistulas are the most devastating complication. Despite the numerous techniques described in the literature, their management remains a challenging task.

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“…The most effective, but not always possible, treatment of EAF is resection of the bowel segment harbouring the fistula opening . If this is impossible due to extensive peritoneal adhesions ( frozen abdomen) , bridging therapy is necessary until relaparotomy and elimination of the fistula can be achieved .…”

Section: Introductionmentioning

confidence: 99%

Successful treatment of enteroatmospheric fistulas in combination with negative pressure wound therapy: Experience on 3 cases and literature review

Wirth

Renz

Andrade

et al. 2018

International Wound Journal

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Enteroatmospheric fistulas (EAF) are rare but challenging and morbid complications of abdominal surgery and require time- as well as resource-consuming management. Furthermore, they severely affect patients' quality of life. Several treatment modalities for EAF management are described in the literature. We describe 3 consecutive cases of EAF treatment by employing negative pressure wound therapy (NPWT) along with either a special silicone fistula adapter or a Silo-Vac-like system in another case to isolate the fistula from the remaining abdominal wound. Spontaneous fistula closure was achieved in 2 of the 3 cases, and surgical resection of the small bowel segment harbouring EAF opening was possible in a third case after wound conditioning. The rate of fistula closure was 100% (n = 3/3). Compartmentalisation of the contaminated area using NPWT accelerated healing of the open abdominal wound remarkably. In summary, we present a useful tool for the challenging management of EAF and review the literature on different treatment options of EAF available today.

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A simple novel technique for enteroatmospheric fistulae: silicone fistula plug

Cited by 21 publications

References 7 publications

Complete abdominal wound and anastomotic leak with diffuse peritonitis closure achieved by an abdominal vacuum sealing drainage in a critical ill patient: a case report

Complete abdominal wound and anastomotic leak with diffuse peritonitis closure achieved by an abdominal vacuum sealing drainage in a critical ill patient: a case report

Enteroatmospheric fistulas - the challenge of the open abdomen

Successful treatment of enteroatmospheric fistulas in combination with negative pressure wound therapy: Experience on 3 cases and literature review

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