Management of enteroatmospheric fistula: A ten-year experience following fifteen years of learning

Wainstein, Daniel E.; Calvi, Rodrigo Juarez; Rezzonico, Florencia; Deforel, Maria Luisa; Perrone, Nora; Sisco, Pablo J.

doi:10.1016/j.surg.2022.12.001

Cited by 6 publications

(4 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…EAFs are a devastating complication of OA treatments and originate when there is a large dehiscence of the abdominal wall or in the case of a “frozen abdomen” [ 15 , 30 , 69 , 70 ]. EAFs are associated with severe morbidity rates, reduced patient health-related quality of life, and increased rates of mortality, duration of hospital stay, and hospital costs [ 71 ].…”

Section: Eaf and Oamentioning

confidence: 99%

“…The management of patients with an OA and an EAF is very challenging [ 18 , 97 ]. These patients are usually critically ill and hypercatabolic and deteriorate rapidly if complications occur during their hospitalization in the intensive care unit.…”

Section: Treatmentmentioning

confidence: 99%

“…Mortality reduction and improvement of a patient’s quality of life are also fundamental. The treatment must include correction of malnutrition, which can be achieved both through parenteral and enteral nutrition even for a long time, and surgical strategies to obtain abdominal closure [ 16 , 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

“…This heterogeneity determines different treatments and a lack of a standardized protocol [ 24 ]. In EAF, the first-choice treatment is conservative, and surgical therapy should be considered only in case of its failure because of the high risk of bowel injury due to the presence of a “frozen abdomen” [ 15 , 25 , 26 , 27 , 28 , 29 , 30 ].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Entero-Cutaneous and Entero-Atmospheric Fistulas: Insights into Management Using Negative Pressure Wound Therapy

Pepe,

Chiarello,

Bianchi

et al. 2024

JCM

View full text Add to dashboard Cite

Enteric fistulas are a common problem in gastrointestinal tract surgery and remain associated with significant mortality rates, due to complications such as sepsis, malnutrition, and electrolyte imbalance. The increasingly widespread use of open abdomen techniques for the initial treatment of abdominal sepsis and trauma has led to the observation of so-called entero-atmospheric fistulas. Because of their clinical complexity, the proper management of enteric fistula requires a multidisciplinary team. The main goal of the treatment is the closure of enteric fistula, but also mortality reduction and improvement of patients’ quality of life are fundamental. Successful management of patients with enteric fistula requires the establishment of controlled drainage, management of sepsis, prevention of fluid and electrolyte depletion, protection of the skin, and provision of adequate nutrition. Many of these fistulas will heal spontaneously within 4 to 6 weeks of conservative management. If closure is not accomplished after this time point, surgery is indicated. Despite advances in perioperative care and nutritional support, the mortality remains in the range of 15 to 30%. In more recent years, the use of negative pressure wound therapy for the resolution of enteric fistulas improved the outcomes, so patients can be successfully treated with a non-operative approach. In this review, our intent is to highlight the most important aspects of negative pressure wound therapy in the treatment of patients with enterocutaneous or entero-atmospheric fistulas.

show abstract

Section: Eaf and Oamentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Entero-Cutaneous and Entero-Atmospheric Fistulas: Insights into Management Using Negative Pressure Wound Therapy

Pepe,

Chiarello,

Bianchi

et al. 2024

JCM

View full text Add to dashboard Cite

show abstract

Establishment and evaluation of an improved rat model of open abdomen

Liu,

Li,

Huang

et al. 2023

Anim Models and Exp Med

View full text Add to dashboard Cite

IntroductionThis study aimed to establish an animal model of open abdomen (OA) through temporary abdominal closure via different techniques.MethodsAdult male Sprague–Dawley rats were randomly divided into three groups: group A (OA with polypropylene mesh alone); group B (OA with polypropylene mesh combined with a patch); and group C (OA with polypropylene mesh and a sutured patch). Vital signs, pathophysiological changes, and survival rates were closely monitored in the rats for 7 days after surgery. Abdominal X‐rays and histopathological examinations were performed to assess abdominal organ changes and wound healing.ResultsThe results showed no significant difference in mortality rates among the three groups (p > 0.05). However, rats in group B exhibited superior overall condition, cleaner wounds, and a higher rate of wound healing compared to the other groups (p < 0.05). Abdominal X‐rays indicated that varying degrees of distal intestinal obstruction in all groups. Histopathological examinations revealed fibrous hyperplasia, inflammatory cell infiltration, neovascularization, and collagen deposition in all groups. Group B demonstrated enhanced granulation tissue generation, neovascularization, and collagen deposition compared to the other groups (p < 0.05).ConclusionsPolypropylene mesh combined with patches is the most suitable method for establishing an animal model of OA. This model successfully replicated the pathological and physiological changes in postoperative patients with OA, specifically the progress of abdominal skin wound healing. It provides a practical and reliable animal model for OA research.

show abstract

Contemporary Management of the Open Abdomen

Slade

2024

Coloproctology

View full text Add to dashboard Cite

Management of enteroatmospheric fistula: A ten-year experience following fifteen years of learning

Cited by 6 publications

References 30 publications

Entero-Cutaneous and Entero-Atmospheric Fistulas: Insights into Management Using Negative Pressure Wound Therapy

Entero-Cutaneous and Entero-Atmospheric Fistulas: Insights into Management Using Negative Pressure Wound Therapy

Establishment and evaluation of an improved rat model of open abdomen

Contemporary Management of the Open Abdomen

Contact Info

Product

Resources

About