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Flexi-SealŪ Tube Use for Enteric Fistula Control in Abdominal Wall Reconstruction

Marc A. Serret, M.D. Christopher J. Salgado, M.D. Brendan Alleyne, B.S.
University Hospitals of Cleveland/Case Western Reserve University Department of Plastic & Reconstruc
2010-03-31

Presenter: Marc A. Serret, M.D.

Affidavit:

Director Name:

Author Category: Resident/Fellow
Presentation Category: Clinical
Abstract Category: General Reconstruction

Introduction: Enteric fistulas can hinder abdominal wall reconstruction efforts when there is a lack of effluent control. If no immediate plan for fistula takedown exists, these patients with superficial enterocutaneous fistulas may require prompt cutaneous reconstruction to reduce their evisceration risk even when fascial competence is not feasible. In this regard, we introduce the use of the Flexi-SealŪ Fecal Management System (FMS) for effluent control of enteric fistulas during complex abdominal wall reconstruction.
Methods: The FMS system was used for enteric fistula effluent control on four patients with an average age of 59, who underwent abdominal wall reconstruction under a single surgeon from July 2007 to November 2009. None of the patients studied had immediate plans for fistula takedown due to their multiple co-morbidities. Abdominal wall reconstruction proceeded by a variety of means ranging from skin grafting to local flap reconstruction. Pre-procedural utilization of the FMS device provided effluent control with a low inflation pressure, and was maintained until reconstruction was complete. In some cases, the above allowed for conversion into a controlled stoma. Follow-up duration ranged from 3 to 12 months with a mean of 6 months.
Results: The FMS device facilitated successful abdominal wall reconstruction in all four patients studied regardless of whether skin grafting or local flap reconstruction was used.
Conclusion: The FMS device serves as a valuable tool in aiding in effluent control in complex abdominal wall reconstruction in patients presenting with enterocutaneous fistulas or enteroatmospheric fistulas.

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