Intra-abdominal pedicled rectus abdominis muscle flap for treatment of high-output enterocutaneous fistulae: Case reports and review of literature

被引:7
作者
Carey, Joseph N. [1 ]
Sheckter, Clifford C. [1 ]
Watt, Andrew J. [2 ]
Lee, Gordon K. [2 ]
机构
[1] Univ So Calif, Keck Sch Med, Los Angeles, CA 90033 USA
[2] Stanford Univ, Med Ctr, Dept Surg, Div Plast & Reconstruct Surg, Stanford, CA 94305 USA
关键词
Enterocutaneous fistula; Pedicled flap; Rectus abdominis; SURGICAL REPAIR; CLOSURE; ABDOMEN;
D O I
10.1016/j.bjps.2012.12.008
中图分类号
R61 [外科手术学];
学科分类号
摘要
Despite advances in nutritional supplementation, sepsis management, percutaneous drainage and surgical technique, enterocutaneous fistulae remain a considerable source of morbidity and mortality. Use of adjunctive modalities including negative pressure wound therapy and fibrin glue have been shown to improve the rapidity of fistula closure; however, the overall rate of closure remains poor. The challenge of managing chronic, high-output proximal enterocutaneous fistulae can be successfully achieved with appropriate medical management and intra-abdominal placement of pedicled rectus abdominis muscle flaps. We report two cases of recalcitrant high output enterocutaneous fistulae that were treated successfully with pedicled intra-abdominal rectus muscle flaps. Indications for pedicled intra-abdominal rectus muscle flaps include persistent patency despite a reasonable trial of non-operative intervention, failure of traditional operative interventions (serosal patch, Graham patch), and persistent electrolyte and nutritional abnormalities in the setting of a high-output fistula. (C) 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:1145 / 1148
页数:4
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