Table 1.

Fundamentals of the current multispecialist approach to enterocutaneous fistula management

Step no.	Treatment basics	Comments
1	Control of sepsis	Often requiring intensive care support Imaging-guided drainage of abscess collections
2	Limiting output volume	Octreotide administration Bowel rest, enteral, or parenteral nutrition
3	Wound or skin care	Use of dressings or bags depending on output Suction or Vacuum-Assisted Closure (VAC) devices if available
4	Metabolic and nutritional optimisation	Adequate hydration, electrolytes balance, nutritional status Proximal versus location in the bowel influences nutritional and fluid requirements
5	Assessing likelihood of spontaneous closure	Versus percutaneous treatment or elective surgical repair Factors associated with favourable healing: - narrow-calibre and/or relatively long (>2 cm) ECFs, - small enteric defect or anastomotic dehiscence (<1 cm) Factors associated with probable non-healing: - presence of foreign bodies, - history of irradiation, - active infection, - untreated chronic inflammatory bowel disease, - untreated tumours, - distal obstruction