For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
23
views
9
references
 Top references
cited by
17
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      346
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

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

      case-report

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          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.

          Related collections

          Most cited references9

          • Record: found
          • Abstract: found
          • Article: not found

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

          K Woodhouse, J Paul Santerre, G Laroche … (2005)
          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.
          Article 0 comments Cited 117 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            Enteric fistulas: principles of management.

            William P Schecter, Asher Hirshberg, David Chang … (2009)
            Article 0 comments Cited 39 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Management of enteroatmospheric fistula with negative pressure wound therapy in open abdomen treatment: a multicentre observational study.

              Adam Bobkiewicz, Dominik Walczak, Szymon Smoliński … (2017)
              The management of enteroatmospheric fistula (EAF) in open abdomen (OA) therapy is challenging and associated with a high mortality rate. The introduction of negative pressure wound therapy (NPWT) in open abdomen management significantly improved the healing process and increased spontaneous fistula closure. Retrospectively, we analysed 16 patients with a total of 31 enteroatmospheric fistulas in open abdomen management who were treated using NPWT in four referral centres between 2004 and 2014. EAFs were diagnosed based on clinical examination and confirmed with imaging studies and classified into low ( 500 ml/day) output fistulas. The study group consisted of five women and 11 men with the mean age of 52·6 years [standard deviation (SD) 11·9]. Since open abdomen management was implemented, the mean number of re-surgeries was 3·7 (SD 2·2). There were 24 EAFs located in the small bowel, while four were located in the colon. In three patients, EAF occurred at the anastomotic site. Thirteen fistulas were classified as low output (41·9%), two as moderate (6·5%) and 16 as high output fistulas (51·6%). The overall closure rate was 61·3%, with a mean time of 46·7 days (SD 43·4). In the remaining patients in whom fistula closure was not achieved (n = 12), a protruding mucosa was present. Analysing the cycle of negative pressure therapy, we surprisingly found that the spontaneous closure rate was 70% (7 of 10 EAFs) using intermittent setting of negative pressure, whereas in the group of patients treated with continuous pressure, 57% of EAFs closed spontaneously (12 of 21 EAFs). The mean number of NPWT dressing was 9 (SD 3·3; range 4-16). In two patients, we observed new fistulas that appeared during NPWT. Three patients died during therapy as a result of multi-organ failure. NPWT is a safe and efficient method characterised by a high spontaneous closure rate. However, in patients with mucosal protrusion of the EAFs, spontaneous closure appears to be impossible to achieve.
              Article 0 comments Cited 17 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Contributors
                Jin-Jian Huang
                Jian-An Ren
                Ge-Fei Wang
                Zong-An Li
                Xiu-Wen Wu
                Hua-Jian Ren
                Song Liu
                Journal
                Journal ID (nlm-ta): World J Gastroenterol
                Journal ID (iso-abbrev): World J. Gastroenterol
                Journal ID (publisher-id): WJG
                Title: World Journal of Gastroenterology
                Publisher: Baishideng Publishing Group Inc
                ISSN (Print): 1007-9327
                ISSN (Electronic): 2219-2840
                Publication date (Print): 7 November 2017
                Publication date (Electronic): 7 November 2017
                Volume: 23
                Issue: 41
                Pages: 7489-7494
                Affiliations
                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@ 123456gmail.com
                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@ 123456gmail.com

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

                Article
                Other ID: jWJG.v23.i41.pg7489
                DOI: 10.3748/wjg.v23.i41.7489
                PMC ID: 5685855
                PubMed ID: 29151703
                SO-VID: f46979c1-dccf-402c-8e68-8a8454b3a0bb
                Copyright © ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
                License:

                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.

                History
                Date received : 19 September 2017
                Date revision received : 29 September 2017
                Date accepted : 18 October 2017
                Categories
                Subject: Case Report

                Keywords: enterocutaneous fistula,3d printing,open abdomen,isolation technique
                Data availability:
                Keywords: enterocutaneous fistula, 3d printing, open abdomen, isolation technique

                Comments

                Comment on this article

                scite_

                Similar content346

                See all similar

                Cited by16

                See all cited by

                Most referenced authors154

                See all reference authors