OPEN ABDOMEN AND ENTEROATMOSPHERIC FISTULAS: THE ENDLESS NIGHTMARE OF SURGEONS. TIPS AND TRICKS FOR ITS MANAGEMENT FROM THE CHAOS TO THE DEFINITIVE TREATMENT sariyak2003@gmail.com

 

OPEN ABDOMEN AND ENTEROATMOSPHERIC FISTULAS: THE ENDLESS NIGHTMARE OF SURGEONS. TIPS AND TRICKS FOR ITS MANAGEMENT FROM THE CHAOS TO THE DEFINITIVE TREATMENT

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Saudi Arabia

Oral or Poster

Open Abdomen (OA) is a surgical method in which the abdominal cavity is left open for treating severe trauma, intra-abdominal sepsis, or compartment syndrome. However, this technique often leads to a variety of complications, of which enteroatmospheric fistulas (EAF) are one critical challenge for the acute care surgeon. This review article is undertaken with the objective of describing the main challenges and complications of OA and EAF and suggesting practical strategies that are workable in their management.

This literature review included studies published up to January 2025. The database searched included Google Scholar, PubMed, Springer, and Web of Science. We used the following keywords “Open abdomen, Enteratmospheric Fistulas, Enteral Nutrition, Negative pressure wound therapy and fistulocytosis”.

OA is lifesaving yet may present complications associated with fluid losses, infection, and development of EAFs. EAFs lead to increased morbidity from high-output fluid losses and metabolic derangements. Nutritional optimization, infection control, and other advanced wound care techniques, including negative pressure wound therapy, go to promise complications reduction. The available temporary abdominal closure techniques currently are facilitating staged closure and reducing risks. Newer innovations such as fistuloclysis, biologic meshes, and regenerative medicine approaches hold promise for the future.

OA and EAF are both significant surgical challenges that need a multidisciplinary approach. Improved outcomes, using advances in wound care, nutritional strategies, and surgical techniques, are not without limitations. Further research is needed to standardize protocols and improve long-term patient care.