Background: About 80% of enterocutaneous fistulas (ECF) occur as a complication of abdominal surgery. while 24% of operated patients with typhoid perforation and 90% of non-operated ones die. Uneven skin surface around ECFs do not allow pouch adherence and adhesive routinely slip due to sweat in our hot tropical climates. Frequent gauze dressing with adhesives. https://www.roneverhart.com/Bioderma-Atoderm-Intensive-Gel-Creme-16-7oz/