Techniques and cost effectiveness of enteroatmospheric fistula isolation

Background. The following describes successful isolation of enteroatmospheric fistulae within a negative pressure wound therapy system (V.A.C.®, KCI, San Antonio, TX). Methods. An impermeable tubular structure was placed around the fistula with a dressing applied to the surrounding wound base, dressed with an impermeable drape and negative pressure, and then an ostomy appliance was placed over the isolated fistula stoma. Cost analysis compared traditional dressings to the NPWT isolation method. Results. All patients underwent fistula isolation with complete diversion of enteric contents. Typical dressing changes occurred 3 times per week. Four patients were discharged from the hospital prior to surgical repair. Conclusion. Successful isolation of enteroatmospheric fistulae using a NPWT system has the potential to lower healthcare system costs by allowing for earlier hospital discharge.