A case of enterocutaneous fistula treated with a dome-shaped negative-pressure irrigation and drainage device.

RATIONALE: Enterocutaneous fistula (ECF) is a severe post-gastrointestinal surgery complication with low cure rates, prolonged treatment cycles, and a global mortality rate of 20% to 44%. Currently, common clinical non-surgical treatments have issues like fluid leakage and inadequate drainage, while existing negative-pressure suction dressings hinder fistula opening observation. Thus, exploring a new therapeutic device integrating "effective drainage, leakage-proof protection, and visual observation" is highly significant for improving ECF patients' prognosis. PATIENT CONCERNS: This article describes a case of a 66-year-old male patient. The patient underwent right hemicolectomy for intestinal obstruction and colon cancer, then emergency laparotomy for hemostasis due to acute intra-abdominal active bleeding postoperatively. On postoperative day 6, abdominal incision dehiscence occurred and was managed with debridement and suturing. Five days after suture, massive digestive fluid leakage (up to 2500 mL daily) was noted from the incision, with a 0.5 × 0.5 cm enterocutaneous fistula identified at the incision base. Abdominal computed tomography showed the fistula was located in the lower part of the incision. Diagnosis: Enterocutaneous fistula. DIAGNOSES: The patient was diagnosed with an enterocutaneous fistula within the incision and a large amount of digestive fluid leakage. INTERVENTIONS: The patient was treated with a dome-shaped negative-pressure irrigation and drainage device covering the enterocutaneous fistula orifice and incision, with continuous negative-pressure irrigation and drainage. Concurrently, adjunctive treatments were given, including anti-infection therapy, parenteral nutritional support, and digestive fluid secretion inhibition. OUTCOMES: After 11 days of treatment with a dome-shaped negative-pressure irrigation and drainage device, the patient's enterocutaneous fistula healed, with fresh granulation tissue in the incision, a significant reduction in the incision area, and normalization of inflammatory markers. LESSONS: In the acute and stable stages of enterocutaneous fistula (ECF), effective fistula drainage is key to promoting fistula healing. The dome-type negative-pressure irrigation and drainage device can enhance drainage efficacy, improve perifistular tissue cleanliness, boost granulation tissue growth, reduce dressing changes, and shorten fistula healing time. This paper aims to demonstrate the feasibility of using this device to promote ECF healing.