Abdominal wall reconstruction in patients with an open abdomen and enterocutaneous fistulas: A nine-step treatment strategy

Enterocutaneous fistulas (ECFs) are serious postoperative complications; less commonly, they result from an inflammatory or oncologic process. No matter what the cause, the consequences can be devastating. The surgeon should have a clear strategy for how to manage ECFs. Particularly when they are associated with an open abdomen or with a large abdominal wall defect requiring complex abdominal wall reconstruction, ECFs lead to a high rate of complications, of failure of the operative intervention, and of mortality. The management of ECFs (whether alone or combined with an abdominal wall defect or an open abdomen) requires a multidisciplinary approach.