ABSTRACT
OBJECTIVE: Enterocutaneous fistula is an unpleasant and troublesome complication of abdominal operations. The objective was to review the outcome of treatment of patients treated for enterocutaneous fistula. MATERIALS AND METHODS: This is a retrospective study of 82 teenage and adult patients, who suffered from enterocutaneous fistula, seen over an 11 year period, in the University of Nigeria Teaching Hospital, Enugu. Patients' charts were reviewed for biodata, etiology of the fistula, volume of the fistula output, and result of treatment. Majority of the fistulas occurred after abdominal operations; many by general practitioners. After treatment for correction of fluid and electrolyte deficits, they were all tried on conservative therapy with enteral nutritional support as the main stay of management. Those, whose fistulas did not close, underwent surgical treatment. Total parenteral nutrition, octreotide, fibrin glue, and wound vacuum assisted closure (VAC) were not used for treating these patients. RESULTS: Spontaneous healing of fistulas occurred in 26 patients (31.7%), whereas 42 patients out of 50 (84%) healed after definitive operation. Fourteen patients (17%) in this study, died. CONCLUSION: Proper management of fluid and electrolyte imbalances, enteral nutritional support, control of sepsis and correctly timed surgical therapy, resulted in this good healing rate and acceptable mortality, without the use of parenteral nutrition, biologic fibrin glue injection or VAC. Suggestions are offered about steps that may help in eradicating some of these enterocutaneous fistulas.
Subject(s)
Cutaneous Fistula/therapy , Intestinal Fistula/therapy , Postoperative Complications/therapy , Adolescent , Adult , Aged , Child , Cutaneous Fistula/surgery , Female , Humans , Intestinal Fistula/surgery , Male , Middle Aged , Postoperative Complications/surgery , Retrospective Studies , Survival Rate , Treatment Outcome , Young AdultABSTRACT
A three year retrospective study of all cases of chemical burns seen at our Plastic Surgery Unit in Enugu, Nigeria showed that chemical burns represented 3.3% of all cases of burns. Even though the series is small, certain aspects of our chemical burns require emphasis. All our cases were due to intentional acts, a fact that is of medico-legal importance. Facial burns with severe ocular injuries leading to blindness was a common finding. In order to reduce morbidity following chemical burns we re-emphasise the importance of early continuous water irrigation of burn wound and involvement of an ophthalmologist in cases where the face is involved. On preventive measures, we suggest that legal restrictions on the sale of potentially injurious chemicals and measures to curb violence and crime in our society will go a long way in alleviating the problem of chemical burns.
