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How to isolate a high output enteroatmospheric fistula in the open abdomen with negative pressure therapy: an institution's step by step guide to the VAC donut |
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| Authors: | Katherine J. L. Suter MBBS FRACS Luke Fairweather MD Yayha Al-Habbal MBBS FRACS Nezor Houli FRACS Rodney Jacobs FRACS Hai T. Bui FRACS |
| Affiliation: | 1. Department of Upper Gastrointestinal and General Surgery, Western Health, Melbourne, Victoria, Australia;2. Department of Upper Gastrointestinal and General Surgery, Western Health, Melbourne, Victoria, Australia Contribution: Conceptualization, Methodology, Supervision;3. Department of Upper Gastrointestinal and General Surgery, Western Health, Melbourne, Victoria, Australia Contribution: Conceptualization, Methodology, Supervision, Validation, Visualization, Writing - review & editing |
| Abstract: | There is multiple evidence to suggest that isolation techniques of high output enteroatmospheric fistulas (EAF) in open abdomens can be advantageous in controlling fistula effluent while allowing time for abdominal wall to granulate. The large loss of proteins, electrolytes and fluid, and the distressing nature of the open abdomen for both patients and doctors, make managing these EAFs a clinical challenge. We present our experience with a high output mucosal protruding EAF and the creation of a ‘VAC donut’ allowing a successful diversion of the enteric content whilst promoting granulation of the tissue bed. |
| Keywords: | enteroatmospheric fistula fistula donut negative pressure wound therapy open abdomen VAC donut |