A low-cost customized silicone floating stoma for the management of high-output entero-atmospheric fistula: a case report.

Entero-atmospheric fistula (EAF) is a serious complication of open abdomen (OA) treatment, especially when high output effluent leads to sepsis, electrolyte imbalance, and wound deterioration. Traditional diversion methods often cannot effectively control production. This report describes a 76-year-old man who developed a high output EAF (about 800 mL/d) after OA due to colonic necrosis and intra-abdominal sepsis. A variety of interventions (including negative pressure wound treatment adjustment, catheter bypass, and attempts to directly repair) were unsuccessful, and the fistula gradually expanded. According to the patient's wound anatomy, a custom-made floating stoma was created using food-grade silicone, which successfully raised the fistula, shunted the effluent, and reduced chemical damage. This case shows that the low-cost and personalized silicone floating stoma can effectively control the high output EAF and protect the wound environment, which is a practical choice in the case of limited resources. Compared with many commercial isolation devices that may cost several hundred US dollars per unit, this customized silicone floating stoma can be manufactured for < $50 per patient.