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.


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.

MeSH terms

  • Abdominal Injuries / complications
  • Abdominal Injuries / physiopathology
  • Abdominal Injuries / surgery*
  • Cutaneous Fistula / etiology
  • Cutaneous Fistula / physiopathology
  • Cutaneous Fistula / surgery*
  • Drainage
  • Humans
  • Intestinal Fistula / etiology
  • Intestinal Fistula / physiopathology
  • Intestinal Fistula / surgery*
  • Negative-Pressure Wound Therapy* / methods
  • Reconstructive Surgical Procedures / methods
  • Skin Transplantation
  • Vacuum
  • Wound Healing*