Skin reconstructive plastic surgery in patients with unformed intestinal fistulas
The study aimed to determine the indications and the possibility of performing skin grafting to eliminate laparostomy wounds in the treatment of unformed intestinal fistulas. The experience of surgical treatment of 62 patients with unformed intestinal fistulas is generalized. Single fistulas were observed in 37 (60%) patients, multiple fistulas - in 25 (40%) patients. The results of the use of the developed staged approach in the treatment of such a category of patients, which provides for the temporary closure of the laparostomy at the first (preparatory) stage due to free autodermoplasty, counter displacement of skin - fatty or skin - fascial flaps, or a combination of these techniques, performed after preparation of the wound defect of the laparostomy under conditions negative pressure. At the second (reconstructive) stage, the method of choice for the final closure of the abdominal cavity is the component - wise division of the abdominal wall and combined skin grafting techniques. The early use of free autodermoplasty is also recommended to close the eventration with the development of purulent complications after the component - wise division of the anterior abdominal wall.