Vacuum-assisted wound care (V.A.C.®) for enteric fistula closure: how we do it.

Abstract

Enterocutaneous fistulas (ECFs) are a surgical problem that is difficult to manage and they have a mortality rate between 6 and 33 % [1]. Many fistulas show a natural tendency to heal; however, the main problem in fistula care usually is adequate drainage of secretions from the wound. Vacuum-assisted wound care (V.A.C. , Kinetic Concept, Inc., San Antonio, TX, USA) therapy can be used to treat intestinal fistulas [2–4]. We successfully treated some cases of ECFs and enteroatmospheric fistulas (EAFs; an EAF is an ECF that opens into the base of a largely disrupted wound with exposed bowel) with the device (Table 1). In our experience, the results we obtained with V.A.C. therapy are strictly related to some tricks used with the black sponge and negative pressure.