A novel method for managing enterocutaneous fistulae in the open abdomen using a pedicle flap

Abstract

A significant proportion of patients with severe intra-abdominal sepsis are managed by leaving the peritoneal cavity open in an attempt to control the infective process, regardless of aetiology. However, a considerable number of these patients develop enterocutaneous fistulae, which compound the clinical situation and delay closure of the peritoneal cavity. We propose a new method of dealing with such fistulae, by simply fashioning a direct pedicle flap to patch the fistulous opening. This method allows control of the fistula and facilitates early closure of the abdomen.