Document Detail


A novel technique to skin graft abdominal wall wounds surrounding enterocutaneous fistulas.
MedLine Citation:
PMID:  20849289     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Enterocutaneous fistulas often are associated with large abdominal wall wounds. Successful skin grafting of these sites is difficult, as the bed is constantly bathed by enteric contents. A method to graft these sites successfully would provide an important advance in their treatment.
METHODS: The medical records of patients undergoing skin grafting of a site around an enterocutaneous fistula were reviewed. The amount of fistula output at the time of grafting was recorded. The method of grafting, as well as the means of protecting the graft from enteric exposure, were noted. Skin grafts were evaluated for the extent of "take."
RESULTS: Seven patients met the inclusion criteria. After 1-2 weeks, the graft take was 90% in three patients, 80% in two patients, and 50% in two patients. After 1 month, there was complete epithelialization in 85% of patients, and the remaining patient had most of the site epithelialized. This healing allowed placement of an ostomy appliance in all patients. The fistula output was >400 mL per day in 70% of the patients. Multiple techniques were used to divert enteric flow away from the graft, but the most common was placement of a negative pressure dressing that concomitantly secured the graft and allowed enteric diversion.
CONCLUSION: The presence of a high-output enterocutaneous fistula does not preclude successful skin grafting. Such grafting can accelerate wound healing as well as improve skin and site hygiene by allowing the placement of an ostomy device.
Authors:
Matthew C Byrnes; Andrew Riggle; Greg Beilman; Jeffrey Chipman
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Publication Detail:
Type:  Journal Article     Date:  2010-09-17
Journal Detail:
Title:  Surgical infections     Volume:  11     ISSN:  1557-8674     ISO Abbreviation:  Surg Infect (Larchmt)     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-10-25     Completed Date:  2011-01-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815642     Medline TA:  Surg Infect (Larchmt)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  505-9     Citation Subset:  IM    
Affiliation:
Department of Trauma, North Memorial Medical Center , Robbinsdale, MN, USA. mbyrnes150@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Abdominal Wall / surgery*
Adult
Aged
Female
Humans
Intestinal Fistula / surgery*
Male
Middle Aged
Ostomy
Skin Transplantation / methods*
Treatment Outcome
Wound Healing
Wounds and Injuries / surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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