Improvised vacuum assisted closure dressing for enterocutenous fistula, a case report

Nyamuryekung'e, Masawa; Yango, Biswalo; Mwanga, Ally; Ali, Athar

doi:10.1016/j.ijscr.2020.11.049

International Journal of Surgery Case Reports

2020

DOI: 10.1016/j.ijscr.2020.11.049

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Improvised vacuum assisted closure dressing for enterocutenous fistula, a case report

Masawa Nyamuryekung'e

Biswalo Yango

Ally Mwanga

et al.

Abstract: Highlights Enterocutaneous fistula is a postoperative complication is 75–80% of the cases that results in metabolic complications. Management of this complication is difficult, necessitating delayed surgery with associated high morbidity and significant mortality. Vacuum-assisted closure (VAC) dressing has been shown to decrease the healing time of chronic wounds and achieves a 64% spontaneous enterocutaneous fistula closure rate. We imp… Show more

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Cited by 2 publications

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Successful outcome of combined surgical and negative pressure therapy in complex enterocutaneous fistulas: a case report

Solís-Pazmiño¹,

Silva²,

Huiracocha³

et al. 2023

Journal of Surgical Case Reports

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An enterocutaneous fistula (ECF) is a complex medical issue that occurs when abnormal communication between the small intestine and the skin occurs. This can lead to the leakage of digestive contents, such as feces and food, onto the skin’s surface. The case of an 86-year-old woman is presented, who developed high-output ECF after undergoing Hartmann surgery, intestinal transit reconstruction for perforated diverticulitis and incisional hernia treatment involving hernioplasty and polypropylene mesh. The patient had suffered from a serous-purulent discharge from a low-volume surgical wound for several years. Despite optimizing the patient’s nutritional status, a laparotomy and small bowel resection were performed successfully. However, using vacuum dressing as a cover for the fistula in the lower gastrointestinal tract remains a subject of debate and limited research. No officially recognized international guidelines recommend its use for small bowel ECF.

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Successful outcome of combined surgical and negative pressure therapy in complex enterocutaneous fistulas: a case report

Solís-Pazmiño¹,

Silva²,

Huiracocha³

et al. 2023

Journal of Surgical Case Reports

View full text Add to dashboard Cite

show abstract

Surgical approach for a refractory enterocutaneous fistula by combining laparoscopic surgery and a planned open conversion: a case report

Hasegawa,

Ogino,

Sekido

et al. 2024

surg case rep

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Background An enterocutaneous fistula (ECF) is defined as an abnormal communication between the gastrointestinal tract and skin. ECFs are rarely encountered in clinical practice, yet are frequently difficult to treat. Few reports exist regarding the surgical techniques for the treatment of an ECF. Therefore, we report a case of refractory ECF with concomitant severe adhesions, in which we performed combined laparoscopic adhesiolysis and planned open conversion. Case presentation A 57-year-old female patient underwent a laparotomy for an ovarian cyst in her 20s. At 46 years, adhesiolysis without bowel resection was performed for adhesive small bowel obstruction (SBO). However, her symptoms did not improve. Eighteen days postoperatively, she underwent a reoperation and jejunostomy. An ECF developed post-reoperation; therefore, stoma closure and radical surgery for the ECF were planned. Due to the severe adhesions, only stoma closure was performed, based on intraoperative assessments. The patient was subsequently referred to our hospital. First, skin care around the fistula was provided during an outpatient visit. Appropriate sizing of the stoma pouch was performed, to improve erosions and ulcers. Thereafter, debridement of the perifistula skin and simple closure of the ECF outlet were attempted; however, the ECF recurred shortly thereafter. After 8 years of regular skin care, with the ECF remaining stable, however, manifesting as symptomatic SBO, she underwent laparoscopic adhesiolysis. This procedure was initiated in the epigastric region, where relatively fewer adhesions were anticipated. Post-open conversion, partial resection of the small intestine at four locations, including the fistula site, was performed. Postoperatively, jejunal edema and peristaltic dysfunction, due to narrowing of the superior mesenteric artery occurred. Regular drainage by percutaneous endoscopic gastrostomy was required. However, she improved and was discharged 3 months post-operatively. Three years post-operatively, the ECF and SBO did not recur. Conclusions We reported a case of refractory ECF in which we were able to safely perform surgery, by combining laparoscopic adhesiolysis and a planned open conversion. Therefore, the surgical approach used in this case may be an option for securing a safe surgical field, while avoiding collateral damage.

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Improvised vacuum assisted closure dressing for enterocutenous fistula, a case report

Cited by 2 publications

References 16 publications

Successful outcome of combined surgical and negative pressure therapy in complex enterocutaneous fistulas: a case report

Successful outcome of combined surgical and negative pressure therapy in complex enterocutaneous fistulas: a case report

Surgical approach for a refractory enterocutaneous fistula by combining laparoscopic surgery and a planned open conversion: a case report

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