Enterocutaneous Fistula and Open Abdominal Wound
Use of NPWT with enterocutaneous fistulae has been found useful for control and diversion of the effluent while promoting healing of the surrounding wound. However, in this case, the enterocutaneous fistula was actually converted to an easier-to-control enterocutaneous fistula that, ultimately, was able to heal in a relatively short time period. As part of the standard recommendations for evaluation of a new fistula, sources for potential sepsis, such as undrained intra-abdominal fluid collections and identification of potential causes of an enteric fistula, are to be explored. In this case, after control of the fistula through the drain, there was no further clinical evidence of intra-abdominal sepsis. Also, because of the patient's transfer to a long-term care facility and lack of scheduled follow-up, no further delineation of the fistula anatomy was able to be completed as recommended by standard of care. By the time the patient returned to the clinic, the fistula and wound were healed and she was clinically well.
Conclusion
Use of NPWT with enterocutaneous fistulae has been found useful for control and diversion of the effluent while promoting healing of the surrounding wound. However, in this case, the enterocutaneous fistula was actually converted to an easier-to-control enterocutaneous fistula that, ultimately, was able to heal in a relatively short time period. As part of the standard recommendations for evaluation of a new fistula, sources for potential sepsis, such as undrained intra-abdominal fluid collections and identification of potential causes of an enteric fistula, are to be explored. In this case, after control of the fistula through the drain, there was no further clinical evidence of intra-abdominal sepsis. Also, because of the patient's transfer to a long-term care facility and lack of scheduled follow-up, no further delineation of the fistula anatomy was able to be completed as recommended by standard of care. By the time the patient returned to the clinic, the fistula and wound were healed and she was clinically well.
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