Showing Latest Articles
Treatment of small-bowel fistulae in the open abdomen with topical negative-pressure therapy
The American Journal of Surgery, 08/15/2011
D'Hondt M et al. – Although previously considered a contraindication to topical negative pressure (TNP) therapy, enteroatmospheric fistulae (EAF) can be managed successfully with TNP therapy. Surgical closure of EAFs is possible after several weeks.
Methods- The authors report their experience with topical negative pressure (TNP) therapy in the management of EAF in an OA using the VAC (vacuum asisted closure) device (KCI Medical, San Antonio, TX).
- Nine patients with 17 EAF in an OA were treated with topical TNP therapy from January 2006 to January 2009.
- Surgery with enterectomy and abdominal closure was planned 6 to 10 weeks later.
- Three EAF closed spontaneously.
- The median time from the onset of fistulization to elective surgical management was 51 days.
- No additional fistulae occurred during VAC therapy.
- One patient with a short bowel died as a result of persistent leakage after surgery.
