title: Colocutaneous fistula management in a dehisced wound: a case study.
abstract: A fistula is an abnormal opening between two or more organs or structures. Wound drainage containment is a key component of nonsurgical fistula management and may include pouches, skin barriers, transparent dressings, troughing procedures, saddle bagging, bridging, and condom and suction catheters used in combination with complex or routine pouching. Following extensive abdominal surgery, the wound of a 50-year-old woman dehisced and a colocutaneous fistula formed inside the wound. The wound containing the fistula, which was draining liquid stool, was too large for existing commercial pouching systems. When initial management efforts, including negative pressure wound therapy, failed to achieve containment goals, clinicians adapted the negative pressure wound therapy dressing to surround the fistula, which helped facilitate therapy while providing a platform for an ostomy appliance to contain the fistula drainage. The system was changed every 2 days until discharge. The wound and fistula management combination improved patient comfort and mobility, facilitated healing, and reduced patient dietary restrictions.
authors.affiliation: Barnes-Jewish Hospital, St. Louis, MO 63110, USA. txr9446@bjc.org
authors.forename: Terri
authors.initials: T
authors.lastname: Reed
authors.forename: Diana
authors.initials: D
authors.lastname: Economon
authors.forename: Laurel
authors.initials: L
authors.lastname: Wiersema-Bryant
mesh_terms: D001458:Bandages; D003108:Colonic Diseases / Q000209:etiology / Q000451:nursing*; D017577:Cutaneous Fistula / Q000209:etiology / Q000451:nursing*; D004322:Drainage / Q000379:methods; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology / Q000451:nursing*; D008875:Middle Aged; D009730:Nursing Assessment; D010347:Patient Care Planning; D011182:Postoperative Care / Q000451:nursing; D017592:Skin Care / Q000295:instrumentation / Q000379:methods* / Q000451:nursing; D013396:Suction / Q000379:methods; D013529:Surgical Wound Dehiscence / Q000150:complications*; D014945:Wound Healing