To evaluate the safety, feasibility, and clinical efficacy of a basement membrane biopatch visceral protective sac in preventing enteroatmospheric fistula during negative pressure-assisted temporary abdominal closure (NPAAC).

A retrospective descriptive study was conducted on 5 patients who underwent NPAAC with the application of the basement membrane biopatch for visceral protection at the Second Affiliated Hospital of Naval Medical University from June 2024 to April 2025. Patient demographics, complication rates, abdominal wound healing status, and hospital length of stay were analyzed.

In this study, there were 5 patients, including two males and three females, with a median age of 57.0 (IQR: 46.0-60.5) years and a median body mass index of 24.8 (IQR: 22.4-27.1) kg/m². The median time from initial surgery to wound opening due to infection was 5.0 (IQR: 4.5-6.0) days. Prior to NPAAC, three patients underwent wound debridement and peritoneal lavage during exploratory laparotomy, while two received temporary ileostomy plus peritoneal lavage during exploratory laparotomy. All five patients survived following NPAAC treatment. The median number of negative- pressure therapy sponge changes was 3.0 (IQR: 2.0-6.0) times. Gastrointestinal function recovery occurred at a median of 3.0 (IQR: 2.0-8.3) days, and the negative-pressure device was removed after a median of 9.0 (IQR: 7.5-31.0) days. Definitive tension-reducing suture closure was performed in three patients, one received split-thickness skin grafting, and one underwent staged abdominal wall reconstruction following stamp grafting. The median total hospital stay was 25.0 (IQR: 22.0-47.5) days. No enteroatmospheric fistula occurred during treatment. Complications mainly included wound bleeding, urinary tract infection, gastric retention, and pulmonary infection, all of which resolved with drug treatment. During a median follow-up of 7.0 (IQR: 4.0-10.5) months, all abdominal wounds healed. One patient developed an incisional hernia, which was managed conservatively.

This study demonstrates that visceral protection with a basement membrane biopatch before NPAAC is a safe and feasible approach, which can effectively reduce the occurrence of enteroatmospheric fistula.