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Catastrophic Abdominal Wall After Repair of Enterocutaneous Fistula

A Case Study

Jerez González, José Antonio; Quiñones Sánchez, Cristina; Márquez Rodríguez, Francisca

Journal of Wound Ostomy & Continence Nursing: July/August 2019 - Volume 46 - Issue 4 - p 337–342
doi: 10.1097/WON.0000000000000539
Challenges in Practice

BACKGROUND: Repair of an enterocutaneous fistula (ECF) is challenging, particularly when complications occur. This case describes the use of negative pressure wound therapy (NPWT) and microadhesive dressings with polyabsorbent fibers and an acrylic core, with and without lipidocolloid and nano-oligosaccharide factors, in the management of a patient with a large abdominal wound and ECF.

CASE: An 84-year-old woman underwent abdominoperineal resection with colostomy, hysterectomy, and subsequent chemotherapy and radiotherapy for colorectal cancer. She experienced complications, ultimately resulting in ECF of the jejunum. Initial management with NPWT was used to promote abdominal wound healing, while protecting exposed bowel loops proved challenging because of leakage of stoma effluent that impeded the formation of granulation tissue. In order to promote wound healing and prevent infection, we applied a microadhesive dressing composed of polyabsorbent fibers with an acrylic core and lipidocolloid and nano-oligosaccharide factors that facilitated autolytic debridement and healing.

CONCLUSIONS: Use of NPWT with the microadhesive dressing proved successful in the management of this complex and challenging ECF.

José Antonio Jerez González, MSC, APN, RN, Bellvitge University Hospital, Barcelona, Spain.

Cristina Quiñones Sánchez, COCN, RN, Bellvitge University Hospital, Barcelona, Spain.

Francisca Márquez Rodríguez, RN, Bellvitge University Hospital, Barcelona, Spain.

Correspondence: José Antonio Jerez González, MSC, APN, RN, Bellvitge University Hospital, C/Feixa Llarga S/N. 08907, L'Hospitalet de Llobregat, Barcelona, Spain (

The authors declare no conflict of interest, and no funding was received for this work from any organization.

© 2019 by the Wound, Ostomy and Continence Nurses Society.