{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T22:09:54Z","timestamp":1783634994819,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,9,3]],"date-time":"2018-09-03T00:00:00Z","timestamp":1535932800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Reconstruction of abdominal wall defects with enterocutaneous fistulas (ECF) remains challenging. The purpose of this report is to describe a single\u2010stage approach using combined microscopic enterolysis, pedicle seromuscular bowel flaps, mesh, fasciocutaneous, and myocutaneous flaps.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between 1990 and 2016 a retrospective review identified a total of 18 patients with an average age of 39\u2009years (ranging 26\u201359\u2009years). Thirteen cases were associated with trauma, four were complication of previous mesh repair, and one was after an aortic dissection. Average diameter of defect size was 22\u2009cm (ranging 20\u201324\u2009cm). Surgical technique involved enterolysis using microscope magnification, a pedicle seromuscular bowel flap to reinforce the bowel anastomosis, mesh, musculocutaneous, and fasciocutaneous flaps to reconstruct the abdominal wall.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifteen patients required rotational flaps with an average skin paddle area of 442.7 cm<jats:sup>2<\/jats:sup> (ranging 440\u2009cm<jats:sup>2<\/jats:sup>\u2013260\u2009cm<jats:sup>2<\/jats:sup>) and 10 patients required a serosal patch with an average length of 5 cm (ranging 4\u20136 cm). Complications included three wound dehiscence and one abdominal wall bulging. Flap survival was 100%. The majority of patients (12 out of 18) were able to resume normal activities, and the remaining (<jats:italic>n<\/jats:italic> = 6) were able to resume most activities. Functional outcome as assessed by 36\u2010Item Short Form Survey (SF\u201036) physical function component questionnaire at 18\u201324\u2009months follow up was 67.8% (ranging from 59 to 72%). Mean length of hospital stay was 2.2 weeks (ranging 1.4\u20132.7 weeks). Mean follow\u2010up was 24\u2009months (ranging 22\u201326\u2009months) with clinical examination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Microscopically assisted intra\u2010abdominal dissection with resection of diseased bowel, replacement with well\u2010vascularized tissue at the anastomosis site in, and reinforcement with mesh combined with pedicle musculocutaneous and fasciocutaneous flaps may be an alternative when other local reconstructive options have failed.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.30374","type":"journal-article","created":{"date-parts":[[2018,9,4]],"date-time":"2018-09-04T05:14:43Z","timestamp":1536038083000},"page":"19-24","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Combined single\u2010stage enterolysis with pedicle seromuscular bowel flaps, myocutaneous and fasciocutaneous flaps to repair recurrent enterocutaneous fistulas in complex abdominal Wall defects"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9688-3079","authenticated-orcid":false,"given":"Kian","family":"Adabi","sequence":"first","affiliation":[{"name":"Dvision of Plastic and Reconstructive Surgery Mayo Clinic  Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar J.","family":"Manrique","sequence":"additional","affiliation":[{"name":"Dvision of Plastic and Reconstructive Surgery Mayo Clinic  Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6143-1849","authenticated-orcid":false,"given":"Aparna","family":"Vijayasekaran","sequence":"additional","affiliation":[{"name":"Dvision of Plastic and Reconstructive Surgery Mayo Clinic  Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven L.","family":"Moran","sequence":"additional","affiliation":[{"name":"Dvision of Plastic and Reconstructive Surgery Mayo Clinic  Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4646-2676","authenticated-orcid":false,"given":"Pedro","family":"Ciudad","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery China Medical University Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0462-7786","authenticated-orcid":false,"given":"Tony C. T.","family":"Huang","sequence":"additional","affiliation":[{"name":"Dvision of Plastic and Reconstructive Surgery Mayo Clinic  Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Nicoli","sequence":"additional","affiliation":[{"name":"University of Rome Tor Vergata Plastic and Reconstructive Surgery  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7660-7576","authenticated-orcid":false,"given":"Sarah","family":"Bishop","sequence":"additional","affiliation":[{"name":"Dvision of Plastic and Reconstructive Surgery Mayo Clinic  Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung\u2010Chi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery China Medical University Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.suc.2013.06.005"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1067\/msy.2000.100886"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181612c99"},{"issue":"5","key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1177\/000313480407000505","article-title":"Repair of giant abdominal hernias: Does the type of prosthesis matter?","volume":"70","author":"Diaz J. 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