What is epithelialization fistula?
A fistula is an abnormal communication between two epithelialized surfaces; an enterocutaneous fistula (ECF), as the name indicates, is an abnormal communication between the small or large bowel and the skin. An ECF can arise from the duodenum, jejunum, ileum, colon, or rectum.
How serious is an enterocutaneous fistula?
Enterocutaneous fistulas (ECFs) are associated with considerable morbidity and mortality. Recent case series suggest a mortality rate of 6 to 33%, with sepsis and concomitant malnutrition being the most common causes of death.
How do you treat enterocutaneous fistula?
Treatment. If the enterocutaneous fistula (ECF) doesn’t heal on its own after a few weeks or months, a complex surgery is required to close the fistula and reconnect the gastrointestinal tract. Patients with ECFs often need specialized wound care, nutritional rehabilitation and physical rehabilitation.
What causes enterocutaneous fistula?
Most ECFs occur after bowel surgery. Other causes include infection, perforated peptic ulcer and inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis. An ECF may also develop from an abdominal injury or trauma, such as a stabbing or gunshot.
What causes epithelialization?
It can be caused by various pathological conditions such as diabetes, trauma and burns. In chronic wounds, the delay of re-epithelialization might be caused by bacterial infection, tissue hypoxia, exudates, local ischemia, and excessive inflammation.
What is Enteroenteric fistula?
A gastrointestinal fistula is an abnormal opening in the stomach or intestines that allows the contents to leak. Leaks that go through to a part of the intestines are called entero-enteral fistulas. Leaks that go through to the skin are called enterocutaneous fistulas.
How long does it take for an enterocutaneous fistula to heal?
Fistulas from the esophagus and duodenum are expected to heal in two to four weeks. Colonic fistulas may heal in 30 to 40 days. Small bowel fistulas may take at least 40 to 60 days.
Are enterocutaneous fistulas painful?
Features suggestive of an enterocutaneous fistula (ECF) include postoperative abdominal pain, tenderness, distention, enteric contents from the drain site, and the main abdominal wound.
How long does enterocutaneous fistula last?
How common are enterocutaneous fistulas?
An enterocutaneous fistula is the most common type and represents 88.2% of all fistulae . Quinn M et al. reported, 89.1% of intestinal cutaneous fistula developed after abdominal surgery, followed by 6.88% occurring spontaneously, and 3.99% occurring after an endoscopic procedure .
What does epithelialization look like?
The process of epidermis regenerating over a partial-thickness wound surface or in scar tissue forming on a full-thickness wound is called epithelialization. The epithelium manifests as light pink with a shiny pearl appearance.
What happens during epithelialization?
Epithelialization is a process of covering defect on the epithelial surface during the proliferative phase that occurs during the hours after injury. In this process, keratinocytes renew continuously and migrate upward from the basal to the differentiated layers.