Does AFB adhere to the bowel and cause fistulae?
No, I have never had the problem, although I must admit, that in the first years of doing STAR I was concerned about that issue myself and often placed a PVC “bowl bag”, cut open, underneath the bur. If you are concerned, you can do that. We never had a problem with adherence or fistula formation resulting from the direct contact of the bowel to the bur. All the fistulae we temporarily saw, originated from an anastomosis or other surgical manipulations. The nice thing about STAR is, that, at the 24 hourly abdominal reentries one can diagnose areas of bowel wall ischemia early, before the actually perforate and before these ischemic , mostly para-anastomotic spots become the origin of a fistula. Another cause of fistulae may be a retained foreign body. STAR reduces the risk of retained foreign body and necrotic tissue, because you may irrigate the entire abdominal cavity during the daily abdominal re-explorations and inspect completely all pouches and corners within the abdomen. If you
