An Ileocutaneous Fistula That Developed 12 Years after Repair of an Abdominal Wall Defect Using Intraperitoneal Placement of High-density Polypropylene Mesh (Marlex®)

The use of negative-pressure wound therapy to manage enteroatmospheric fistulae in two patients with large abdominal wounds

Enteric fistulae are a relatively common complication of bowel surgery or in surgery where the bowel has been exposed. Fistulae can present a significant threat to patients' well-being. Changes in surgical techniques and in particular the rise in damage control surgery for emergency patients have led to an increase in open abdominal wounds. The presence of an enteroatmospheric fistula on the surface of a wound can cause a number of distressing symptoms/issues for the patient whilst providing a significant challenge for the clinician. The loss of fluid, proteins and electrolytes will place the patient in danger of becoming hypokalaemic and malnourished. A variety of techniques are available, most refer to a method of isolating the fistula using stoma rings or washers and ostomy paste. The role of negative pressure in the management of wounds with fistula is in its infancy; however, there is evidence to suggest that isolation techniques can be advantageous in managing wounds with fistulae.