Fistula repair after hypospadias surgery using buccal mucosal graft.
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INTRODUCTION: The aim of this study was to evaluate the success rate of urethrocutaneous fistula repair using buccal mucosal graft in patients with a previous hypospadias repair. MATERIALS AND METHODS: We reviewed records of our patients with urethrocutaneous fistula developed after hypospadias repair in whom buccal mucosal graft fistula repair had been performed. All of the patients had been followed up for 24 postoperative months. A successful surgical operation was defined as no fistula recurrence or urethral stricture. Retrograde urethrography and urethrocystoscopy would be performed in patients who had any history of decreased force and caliber of urine or any difficulty in urination. RESULTS: Fistula repair using buccal mucosa patch graft had been done in 14 children with urethrocutaneous fistula developing after hypospadias reconstruction. The mean age of the children was 8.70 +/- 1.99 years old (range, 4 to 11 years). Seven fistulas were in the midshaft, 4 were in the penoscrotal region, and 3 were in the coronal region. Repair of the fistulas was successful in 11 of 14 patients (78.6%). In the remaining children, the diameter of the fistula was smaller than that before the operation, offering a good opportunity for subsequent closure. CONCLUSION: Our findings showed that fistula repair using buccal mucosal graft can be one of the acceptable techniques for repairing fistulas developed after hypospadias repair. (+info)
Closure of a nonhealing gastrocutanous fistula using argon plasma coagulation and endoscopic hemoclips.
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A case in which a gastrocutaneous fistula developed after percutaneous endoscopic gastrostomy tube placement is presented. The fistula was first managed conservatively, then was closed by argon plasma coagulation and hemoclip placement. The patient was observed and was discharged once the gastrocutaneous fistula closed. (+info)
Pharyngocutaneous fistula after anterior cervical spine surgery.
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Vesicocutaneous fistula presenting as a thigh abscess.
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Secondary thigh abscesses are rare, and their cause is often obscure. We report a 90-year-old man who complained of a thigh abscess that was found to be secondary to a vesicocutaneous fistula. He had previously sustained a pelvic fracture and vesical injury from a road traffic accident two years prior to this diagnosis. (+info)
A simple device for closure of a colocutaneous fistula within the laparotomy wound: a case report.
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Colocutaneous fistulas within laparotomy wounds are rare and difficult to treat. Surgical repair may be contraindicated or not desired and negative pressure wound therapy may not be successful. A simple device made from a silicone, flexi-aid hand exerciser was used to close a colocutaneous fistula within the laparotomy wound of a 50-year old man following surgery of an esophageal carcinoma and a surgical history of Whipple's procedure for adenocarcinoma of the ampulla of Vater. His wound developed 9 days postoperatively, measured 8 cm x 3 cm x 2 cm, and was contaminated with fecal material. Initial efforts involving cleansing and the use of negative pressure wound therapy were unsuccessful and the patient refused additional surgery. In this patient, a silicone occlusion device, used in conjunction with a silver hydrofiber dressing, prevented fecal soiling and facilitated closure of the colocutaneous fistula and the laparotomy wound. He was discharged on postop day 22 and healed by postop day 64. This was the first time this approach was used. Studies to optimize nonsurgical management approaches of these complicated conditions are needed. (+info)
Managing complex, high-output, enterocutaneous fistulas: a case study.
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Gastrointestinal (GI) fistulas are an uncommon but serious complication. Following diagnosis, management strategies may have to be adapted frequently to address changes in fistula output, surrounding skin or wound condition, overall patient clinical and nutritional status, mobility level, and body contours. Following a motor vehicle accident, a 49-year-old man with a body mass index of 36.8 and a history of multiple previous surgeries, including gastric bypass, experienced excessive output from a fistula within a large open abdominal wound measuring 45 cm x 40 cm x 5 cm. Abdominal creases and the need to protect a split-thickness skin graft of the wound surrounding his fistula complicated wound management. During his prolonged 4-month hospital stay, the patient underwent several surgical procedures, repeated wound debridement, and various nutritional support interventions; a wide variety of wound and fistula management systems were utilized. One year after the initial trauma, the fistula was surgically closed. One week later, the patient died from a cardiac event. This case study confirms that GI fistulas increase costs of care and hospital length of stay and require the experience and expertise of a wide array of patient support staff members and clinicians. (+info)