Pacifying the open abdomen with concomitant intestinal fistula: a novel approach |
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Authors: | Maj Brian Layton Maj Joe DuBose Maj Shawnn Nichols Lt Col James Connaughton Lt Col Tracy Jones Col Jerry Pratt |
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Institution: | a Department of Surgery, Wake Forest University Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC 27157 b 332nd Air Force Theater Hospital, Balad, Iraq |
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Abstract: | The management of the open abdomen, particularly when complicated by the presence of intestinal fistula, remains a significant challenge of modern trauma care. Although several approaches have been proposed, these varied and complex cases defy the application of a universal approach to local therapy. Ultimately, abdominal closure is desired but is not always possible. Accordingly, surgeons must be well versed in the application of a number of useful approaches that may serve to facilitate control of fistula drainage while permitting management of the surrounding open wound. We contribute a management approach that is simplistic in design, provides for effective fistula control, and permits the subsequent unhindered granulation of the surrounding wound in abdomens not amenable to delayed closure techniques. |
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Keywords: | Intestinal fistula Open abdomen Enterocutaneous fistula Wound vac Abdominal sepsis Trauma |
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