Autologous reconstruction of massive enteroatmospheric fistulation with a pedicled subtotal lateral thigh flap

The British Journal of Surgery
G LambeGordon Lawrence Carlson

Abstract

Reconstruction of massive contaminated abdominal wall defects associated with enteroatmospheric fistulation represents a technical challenge. An effective technique that allows closure of intestinal fistulas and reconstruction of the abdominal wall, with a good functional and cosmetic result, has yet to be described. The present study is a retrospective review of simultaneous reconstruction of extensive gastrointestinal tract fistulation and large full-thickness abdominal wall defects, using a novel pedicled subtotal thigh flap. The flap, based on branches of the lateral circumflex femoral artery, was used to reconstruct the abdominal wall in six patients who were dependent on artificial nutritional support, with a median (range) of 4·5 (3-23) separate intestinal fistulas, within open abdominal wounds with a surface area of 564·5 (204-792) cm2. Intestinal reconstruction was staged, with delayed closure of a loop jejunostomy. Median follow-up was 93·5 (10-174) weeks. Successful healing occurred in all patients, with no flap loss or gastrointestinal complications. One patient died from complications of sepsis unrelated to the surgical treatment. All surviving patients gained complete nutritional autonomy following closure of the ...Continue Reading

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Citations

Feb 13, 2016·Langenbeck's Archives of Surgery·Salomone Di SaverioGregorio Tugnoli
Sep 17, 2013·The Surgical Clinics of North America·Dominic Alexander James Slade, Gordon Lawrence Carlson
Mar 11, 2016·British Journal of Hospital Medicine·Nicholas Stylianides, Dominic A J Slade
Aug 24, 2016·The Journal of Trauma and Acute Care Surgery·Osvaldo ChiaraEmiliano Cingolani

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