Staged management of the open abdomen and enteroatmospheric fistulae using split-thickness skin grafts

Jennifer E. Cheesborough, Eugene Park, Jason M. Souza, Gregory A. Dumanian*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Background Management of the open abdomen with polyglactin 910 mesh followed by split-thickness skin grafts allows safe, early closure of abdominal wounds. This technique can be modified to manage enteroatmospheric fistulae. Staged ventral hernia is performed in a less inflamed surgical field. Methods A retrospective review was performed of 59 consecutive patients who underwent abdominal skin grafting for open abdominal wounds from 2001 to 2011. Results The median length of follow-up was 215 days. Thirty-one percent of patients presented with preexisting enteroatmospheric fistulae, and 41% required polyglactin 910 mesh placement before skin grafting. Partial or complete skin graft failure occurred in 7 patients. Four patients required repeat skin grafting. All patients ultimately achieved abdominal wound closure, and none developed de novo fistulae. Conclusions With proper technique, skin grafting of the open abdomen with a planned ventral hernia repair is a safe and effective alternative to delayed primary closure.

Original languageEnglish (US)
Pages (from-to)504-511
Number of pages8
JournalAmerican journal of surgery
Volume207
Issue number4
DOIs
StatePublished - Apr 2014

Keywords

  • Abdominal wall reconstruction
  • Enteroatmospheric fistula
  • Enterocutaneous fistula
  • Open abdomen
  • Skin graft

ASJC Scopus subject areas

  • Surgery

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