Vacuum-assisted closure for cutaneous gastrointestinal fistula management

Background. Cutaneous gastrointestinal (GI) fistulas are a challenging comp lication in the oncologic patient population. The fistulous effluent is dif ficult to manage and adversely alters quality of life. Nonsurgical manageme nt of enteric fistulas is successful in 30% of cases, requiring at least 4 to 6 weeks. Recently a new technology has been developed to expedite wound healing. The Vacuum-Assisted Closure (VAC) method is a subatmospheric press ure technique that has been demonstrated in laboratory and clinical studies to significantly improve wound healing. Here we report its use in the succ essful medical management of a cutaneous GI fistula. Case. A 63-year-old woman with advanced ovarian cancer developed an extensi ve complex cutaneous GI fistula in an open healing wound. She was treated w ith total parental nutrition and the VAC device, which resulted in complete closure of the fistula. Conclusion. We propose that the VAC device may be a useful adjunct for the medical management of cutaneous GI fistulas. (C) 2001 Academic Press.