关键词: 腹腔开放, 肠空气瘘, 腹壁毁损, 瘘口封堵, 外科重建 

Abstract: Enteroatmospheric fistula (EAF) accompanied by abdominal wall defects represents a complex surgical complication that severely impacts patients’ quality of life and prognosis. Its incidence ranges from 8% to 20% in cases involving an open abdomen and EAF is often associated with extensive damage to the abdominal wall tissues. The management of EAF relies on staged surgical strategies. The initial phase focuses on controlling the source of infection and stabilizing systemic conditions by improving drainage and antibiotic therapy to reduce intra-abdominal contamination and maintain fluid-electrolyte balance and nutritional support. The intermediate phase involves fistula management, employing techniques such as drainage, fistula occlusion, and negative pressure wound therapy to promote healing while minimizing infection and electrolyte disturbances. The definitive phase entails surgical reconstruction to restore intestinal continuity and abdominal wall integrity, with repair strategies tailored to the extent of tissue destruction. Emerging technologies, including 3D-printed enterocutaneous fistula stents, biological meshes, and smart materials, have demonstrated promising clinical potential. Studies indicate that personalized therapeutic protocols integrating advanced technologies significantly improve clinical outcomes, reduce complications, and enhance patients’ survival rates and quality of life. Future advancements in technology are expected to enable more precise and individualized approaches to EAF management.

Key words: open abdomen, enteroatmospheric fistula, abdominal wall defects, fistula closure, surgical reconstruction