Combine Endoluminal Vacuum-Assisted Closure with Basement Membrane Graft for the Treatment of Gastrointestinal Cutaneous Fistula

Excerpt

A 59-year-old male patient was diagnosed of anastomotic cutaneous fistulas on the 10th day after stomal retraction with sinus tracts 5 cm and 2 cm in length, respectively. The fistula did not heal using suture, fibrin glue, and cyanoacrylate glue [1, 2]. We then cut the basement membrane graft (Antisan, Zhuo Ruan Medical) into suitable shape and inserted it into the sinus (Fig. 1a), together with a self-made bullet-shaped endoluminal vacuum-assisted closure device (Fig. 1b). After one week of treatment, the sinus tract was closed (Fig. 1c). A 66-year-old male patient developed two gastrocutaneous fistulas 8 days after left hemicolectomy and partial gastrectomy. After 3 months of treatment with negative pressure wound therapy [3], the sinus tract was reduced to 2 cm in length and 2 mm in diameter (Fig. 2a), but was difficult to close. Eventually, the sinus were closed after 9 days of treatment with the combination of negative pressure and basement membrane as described above (Fig. 2b).

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