Reconstruction of complex abdominal wall defects with enteric fistulae with strattice reconstructive tissue matrix

Introduction: Management of complex abdominal wall defects with development of enteric fistulae still remains a surgical challenge in the treatment of patients. We present a mini-series of patients with successful closure of an abdomen apertum using a porcine acellular dermal matrix.

Patients and methods: We report on 4 patients aged between 38 and 67 years, who developed a complex abdominal wall defect with enteric fistula after a surgical intervention. All of them underwent simultaneous closure of the fistula with reconstruction of the abdominal wall with Strattice Reconstructive Tissue Matrix. At that time the wound was treated by a negative pressure wound therapy with secondary closure by mesh graft transplantation. Surgery was performed in the years 2010 and 2011 with a follow-up of patients of one year.

Results: In all patients the defect could be closed without recurrence of fistulae. Patients that were initially on total parenteral nutrition due to a short small bowel syndrome could be switched to total enteral nutrition. Cosmetic results were good with a high patients' satisfaction.

Conclusion: Closure of complex abdominal wall defects with enteric fistulae with a bioprothetic mesh seem to be a promising therapy in critically ill patients.