“Enterocutaneous Fistula (ECF) is defined as an abnormal connection between the gastrointestinal tract and the skin, and it requires labor-intensive medical management and surgical expertise. Complex wound management, severe malnutrition, frequent infectious complications, chronic pain, and depression require significant investment of health care resources and make the short-term and long-term care of these patients difficult.”

“Results of this study demonstrate that careful selection of patients, aggressive preoperative management, judicious intraoperative technique, and vigilant postoperative care are essential for successful outcomes following the surgical closure of ECF. In particular, preoperative
nutritional optimization, abdominal fascia closure, and prevention of postoperative complications remain paramount for preventing refistulization and postoperative
mortality.”

Owen, Rachel M et al. “Definitive surgical treatment of enterocutaneous fistula: outcomes of a 23-year experience.” JAMA surgery vol. 148,2 (2013): 118-26.