“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 longterm care of these patients difficult. The
subsequent operative management often requires lengthy procedures in hostile abdomens with abundant adhesions and surrounding inflammation. In addition to the significant risk of mortality, morbidity can be equally as devastating.”

“Results of our 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. Free Full Text