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      3D-printed “fistula stent” designed for management of enterocutaneous fistula: An advanced strategy

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          Enterocutaneous fistulas (ECFs) are great challenges during the open abdomen. The loss of digestive juice, water-electrolyte imbalance and malnutrition are intractable issues during management of ECF. Techniques such as “fistula patch” and vacuum-assisted closure therapy have been applied to prevent contamination of open abdominal wounds by intestinal fistula drainage. However, failures are encountered due to high-output fistula and anatomical complexity. Here, we report 3D-printed patient-personalized fistula stent for ECF treatment based on 3D reconstruction of the fistula image. Subsequent follow-up demonstrated that this stent was well-implanted and effective to reduce the volume of enteric fistula effluent.

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          Most cited references 9

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          Understanding the biodegradation of polyurethanes: from classical implants to tissue engineering materials.

          After almost half a century of use in the health field, polyurethanes (PUs) remain one of the most popular group of biomaterials applied for medical devices. Their popularity has been sustained as a direct result of their segmented block copolymeric character, which endows them with a wide range of versatility in terms of tailoring their physical properties, blood and tissue compatibility, and more recently their biodegradation character. While they became recognized in the 1970s and 1980s as the blood contacting material of choice in a wide range of cardiovascular devices their application in long-term implants fell under scrutiny with the failure of pacemaker leads and breast implant coatings containing PUs in the late 1980s. During the next decade PUs became extensively researched for their relative sensitivity to biodegradation and the desire to further understand the biological mechanisms for in vivo biodegradation. The advent of molecular biology into mainstream biomedical engineering permitted the probing of molecular pathways leading to the biodegradation of these materials. Knowledge gained throughout the 1990s has not only yielded novel PUs that contribute to the enhancement of biostability for in vivo long-term applications, but has also been translated to form a new class of bioresorbable materials with all the versatility of PUs in terms of physical properties but now with a more integrative nature in terms of biocompatibility. The current review will briefly survey the literature, which initially identified the problem of PU degradation in vivo and the subsequent studies that have led to the field's further understanding of the biological processes mediating the breakdown. An overview of research emerging on PUs sought for use in combination (drug + polymer) products and tissue regeneration applications will then be presented.
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            Enteric fistulas: principles of management.

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              Classification, prevention and management of entero-atmospheric fistula: a state-of-the-art review.

              Entero-atmospheric fistula (EAF) is an enteric fistula occurring in the setting of an open abdomen, thus creating a communication between the GI tract and the external atmosphere. Management and nursing of patients suffering EAF carries several challenges, and prevention of EAF should be the first and best treatment option.

                Author and article information

                World J Gastroenterol
                World J. Gastroenterol
                World Journal of Gastroenterology
                Baishideng Publishing Group Inc
                7 November 2017
                7 November 2017
                : 23
                : 41
                : 7489-7494
                Department of Surgery, Jinling Hospital, Nanjing 210002, Jiangsu Province, China
                School of Medicine, Southeast University, Nanjing 210009, Jiangsu Province, China
                Department of Surgery, Jinling Hospital, Nanjing 210002, Jiangsu Province, China. jiananr@
                Department of Surgery, Jinling Hospital, Nanjing 210002, Jiangsu Province, China
                NARI School of Electrical and Automation Engineering, Nanjing Normal University, Nanjing 210042, Jiangsu Province, China
                Department of Surgery, Jinling Hospital, Nanjing 210002, Jiangsu Province, China
                Department of Surgery, Jinling Hospital, Nanjing 210002, Jiangsu Province, China
                Department of General Surgery, Nanjing Drum Tower Hospital, Nanjing 210008, Jiangsu Province, China
                Author notes

                Author contributions: Huang JJ and Ren JA designed this report; Wang GF performed the 3D-reconstructed fistulography; Huang JJ and Li ZA fabricated this 3D-printed fistula stent; Ren JA and Ren HJ implanted the fistula stent; Wu XW and Liu S followed up the patient and recorded his medical information.

                Correspondence to: Jian-An Ren, MD, FACS, Director, Department of Surgery, Jinling Hospital, 305 East Zhongshan Road, Nanjing 210002, Jiangsu Province, China. jiananr@

                Telephone: +86-13605169808 Fax: +86-25-80860376

                ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.

                This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

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