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Successful bridging treatment and healing of enteric fistulae by vacuum-assisted closure (VAC) therapy and targeted drainage in patients with open abdomen

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Abstract

Purpose

The object of this study was to investigate the bridging treatment of enteric fistulae by vacuum-assisted closure (VAC) therapy in patients with open abdomen.

Methods

We retrospectively analyzed patients who have been treated between 1 January 2007 and 31 December 2008 at the intensive care unit of the Department of General Surgery, Medical University Vienna. Control of the fistula was established by VAC therapy to bridge the patients to the time of the fistula resection.

Results

In the period of investigation, we treated nine (six men/three women) patients suffering from enteric fistulae with VAC therapy. The median age of the patients was 48 (range, 37–67) years. The median duration of VAC therapy was 76 (range, 53–128) days. The median length of stay in the intensive care unit was 44 (range, 25–127) days. The median APACHE II score was 23 (range, 18–25). The predicted mortality was 40%; the actual mortality was 11% (one patient). Primary fascial closure was achieved after median 91 (range, 89–92) days in three patients (33%) and secondary fascial closure after median 292 (range, 252–546) days in another three patients (33%). Fistulae were cured with VAC (five patients, 56%) and surgical resection (three patients, 33%). None of the patients developed a refistulation at the time of follow-up.

Conclusions

Control of enteric fistulae by VAC therapy can lead to spontaneous fistula closure and is associated with a low mortality.

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Acknowledgments

The authors thank Anneliese Raab and the nursing staff at the ICU of the Department of General Surgery, Medical University Vienna, for caring for the patients and providing their clinical experience for the interpretation of data.

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None.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of General Surgery, Medical University Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Stefan Stremitzer, Andrea Dal Borgo, Thomas Wild & Peter Goetzinger

Authors
  1. Stefan Stremitzer
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  2. Andrea Dal Borgo
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  3. Thomas Wild
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  4. Peter Goetzinger
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Corresponding author

Correspondence to Stefan Stremitzer.

Additional information

The study has been approved by the local ethics committee.

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Stremitzer, S., Dal Borgo, A., Wild, T. et al. Successful bridging treatment and healing of enteric fistulae by vacuum-assisted closure (VAC) therapy and targeted drainage in patients with open abdomen. Int J Colorectal Dis 26, 661–666 (2011). https://doi.org/10.1007/s00384-010-1126-z

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  • DOI: https://doi.org/10.1007/s00384-010-1126-z

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