肠-气腔瘘的处理。
Management of enteroatmospheric fistulae.
机构信息
Department of Surgery, Dokuz Eylul University Hospital, Izmir, Turkey.
出版信息
Int Wound J. 2014 Jun;11 Suppl 1(Suppl 1):17-21. doi: 10.1111/iwj.12288.
Abstract
A small-bowel enteroatmospheric fistula (EAF) is an especially challenging complication for patients with open abdomens (OAs) and their surgeons. Manipulation of the bowel during treatment (e.g. dressing changes) is one of the risk factors for developing these openings between the atmosphere and the gastrointestinal tract. Unlike enterocutaneous fistulae, EAFs have neither overlying soft tissue nor a real fistula tract, which reduces the likelihood of their spontaneous closure. Surgical closure is necessary but not always easy to do in the OA environment. Negative pressure wound therapy (NPWT) has been used successfully as an adjunct therapy to heal the wound around EAFs. This review discusses many aspects of managing EAFs in patients with OAs, and presents techniques that have been developed to isolate the fistula and divert effluent while applying NPWT to the surrounding wound bed.
摘要
小肠肠腔-大气道瘘（EAF）是开放式腹部（OA）患者及其外科医生面临的一项极具挑战性的并发症。在治疗过程中（例如换药）对肠道的操作是导致这种大气道与胃肠道之间出现开口的危险因素之一。与肠外瘘不同，EAF 既没有覆盖的软组织，也没有真正的瘘管通道，这降低了其自发闭合的可能性。手术闭合是必要的，但在 OA 环境中并不总是容易做到。负压伤口治疗（NPWT）已成功用作辅助治疗方法来治愈 EAF 周围的伤口。本综述讨论了 OA 患者中 EAF 管理的多个方面，并介绍了一些技术，这些技术旨在隔离瘘管并引流流出物，同时对周围伤口床应用 NPWT。
相似文献
1
Management of enteroatmospheric fistulae.
Int Wound J. 2014 Jun;11 Suppl 1(Suppl 1):17-21. doi: 10.1111/iwj.12288.
2
Management of enteroatmospheric fistula with negative pressure wound therapy in open abdomen treatment: a multicentre observational study.
Int Wound J. 2017 Feb;14(1):255-264. doi: 10.1111/iwj.12597. Epub 2016 Mar 22.
3
"Enteroatmospheric fistulae"--gastrointestinal openings in the open abdomen: a review and recent proposal of a surgical technique.
Scand J Surg. 2013;102(2):61-8. doi: 10.1177/1457496913482252.
4
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.
ANZ J Surg. 2023 Mar;93(3):682-686. doi: 10.1111/ans.18270. Epub 2023 Jan 11.
5
A simple novel technique for enteroatmospheric fistulae: silicone fistula plug.
Int Wound J. 2014 Jun;11 Suppl 1(Suppl 1):22-4. doi: 10.1111/iwj.12308.
6
The Use Of Negative Pressure Wound Therapy (NPWT) In The Management Of Enteroatmospheric Fistula--Case Report And Literature Review.
Pol Przegl Chir. 2015 Oct;87(10):522-7. doi: 10.1515/pjs-2015-0098.
7
The use of negative-pressure wound therapy to manage enteroatmospheric fistulae in two patients with large abdominal wounds.
Int Wound J. 2014 Dec;11(6):723-9. doi: 10.1111/iwj.12038. Epub 2013 Mar 13.
8
Impact of negative pressure wound therapy on enteroatmospheric fistulation in the septic open abdomen.
Colorectal Dis. 2023 Jan;25(1):111-117. doi: 10.1111/codi.16318. Epub 2022 Sep 20.
9
Successful treatment of enteroatmospheric fistulas in combination with negative pressure wound therapy: Experience on 3 cases and literature review.
Int Wound J. 2018 Oct;15(5):722-730. doi: 10.1111/iwj.12916. Epub 2018 Mar 30.
10
Combined management of open abdomen with enteroatmospheric fistula by negative pressure instill wound therapy and dermal matrix wound dressing.
Ann Ital Chir. 2021 Jun 21;10:S2239253X21036367.
引用本文的文献
1
Effectiveness of vacuum-assisted wound closure and mesh-mediated fascial traction in open abdomen management.
Surg Today. 2025 Mar;55(3):335-342. doi: 10.1007/s00595-024-02899-7. Epub 2024 Jul 24.
2
Entero-Cutaneous and Entero-Atmospheric Fistulas: Insights into Management Using Negative Pressure Wound Therapy.
J Clin Med. 2024 Feb 23;13(5):1279. doi: 10.3390/jcm13051279.
3
An alternative negative pressure treatment for enteroatmospheric fistula resulting from small intestinal leakage caused by incision dehiscence.
Heliyon. 2023 Nov 4;9(11):e22045. doi: 10.1016/j.heliyon.2023.e22045. eCollection 2023 Nov.
4
4D-printed bilayer hydrogel with adjustable bending degree for enteroatmospheric fistula closure.
Mater Today Bio. 2022 Jul 14;16:100363. doi: 10.1016/j.mtbio.2022.100363. eCollection 2022 Dec.
5
Failure to Rescue (FTR) and Pitfalls in the Management of Complex Enteric Fistulas (CEF): From Rescue Surgery to Rescue Strategy.
J Pers Med. 2022 Feb 16;12(2):292. doi: 10.3390/jpm12020292.
6
Unusual techniques in the management of enteroatmospheric fistula. Report of a case.
Int J Surg Case Rep. 2020;75:292-296. doi: 10.1016/j.ijscr.2020.09.024. Epub 2020 Sep 10.
7
The successful management for long-term intractable enteroatmospheric fistula: A case report.
Ann Med Surg (Lond). 2020 Jul 30;57:253-256. doi: 10.1016/j.amsu.2020.07.044. eCollection 2020 Sep.
8
Application of a 3D-printed "fistula stent" in plugging enteroatmospheric fistula with open abdomen: A case report.
World J Gastroenterol. 2019 Apr 14;25(14):1775-1782. doi: 10.3748/wjg.v25.i14.1775.
9
Surgery for post-operative entero-cutaneous fistulas: is bowel resection plus primary anastomosis without stoma a safe option to avoid early recurrence? Report on 20 cases by a single center and systematic review of the literature.
G Chir. 2017 Jul-Aug;38(4):185-198. doi: 10.11138/gchir/2017.38.4.185.
10
Laparoscopically assisted treatment of entero-atmospheric fistula following abdominal wall repair of complex incisional hernia: Case report.
Int J Surg Case Rep. 2017;39:136-139. doi: 10.1016/j.ijscr.2017.07.059. Epub 2017 Aug 8.
本文引用的文献
1
Techniques and cost effectiveness of enteroatmospheric fistula isolation .
Wounds. 2010 Aug;22(8):212-7.
2
Controversies in the care of the enterocutaneous fistula.
Surg Clin North Am. 2013 Feb;93(1):231-50. doi: 10.1016/j.suc.2012.09.009. Epub 2012 Oct 18.
3
Vacuum and mesh-mediated fascial traction for primary closure of the open abdomen in critically ill surgical patients.
Br J Surg. 2012 Dec;99(12):1725-32. doi: 10.1002/bjs.8914. Epub 2012 Oct 3.
4
Enteroatmospheric fistula: from soup to nuts.
Nutr Clin Pract. 2012 Aug;27(4):507-12. doi: 10.1177/0884533612444541. Epub 2012 Jun 8.
5
Metabolic and nutritional support of the enterocutaneous fistula patient: a three-phase approach.
World J Surg. 2012 Mar;36(3):524-33. doi: 10.1007/s00268-011-1315-0.
6
Management of enterocutaneous fistulas.
Surg Clin North Am. 2011 Jun;91(3):481-91. doi: 10.1016/j.suc.2011.02.004.
7
Treatment of small-bowel fistulae in the open abdomen with topical negative-pressure therapy.
Am J Surg. 2011 Aug;202(2):e20-4. doi: 10.1016/j.amjsurg.2010.06.025. Epub 2011 May 23.
8
Pacifying the open abdomen with concomitant intestinal fistula: a novel approach.
Am J Surg. 2010 Apr;199(4):e48-50. doi: 10.1016/j.amjsurg.2009.06.028.
9
Management of the open abdomen: from initial operation to definitive closure.
Am Surg. 2009 Nov;75(11 Suppl):S1-22.
10
Use of topical negative pressure in assisted abdominal closure does not lead to high incidence of enteric fistulae.
Colorectal Dis. 2010 Sep;12(9):931-4. doi: 10.1111/j.1463-1318.2009.01929.x. Epub 2009 Apr 28.
Zotero 插件