ABSTRACT
Surgeons who regularly operate for enterocutaneous fistulas have developed an increasing understanding of the critical importance of abdominal wall reconstruction in determining outcomes, where traditionally the focus has been on the intestinal component of the operation. An intestinal fistula can result from an intrinsic disease of the gastrointestinal tract, but more commonly arises as an iatrogenic complication of abdominal surgery. Aggressive elimination of sepsis is the key determinant of a successful outcome for patients with an enterocutaneous fistula. Patients with an enterocutaneous fistula typically have had multiple and prolonged periods of time in hospital, often with associated surgical misadventure and ICU admissions. The risk of incisional hernia is clearly higher with sutured techniques but this can always be addressed at a later stage and removal of the fistula by restoration of gut continuity allows the use of permanent synthetic reinforcement in any future surgery.
