title: Management of fistulae in the abdominal region.
abstract: OBJECTIVE
  We evaluated a new fistula and wound management system; ostomy and wound care nurses were queried about willingness to use the product in future patients, product wear time and pouch leakage, perifistular skin condition, access for wound care, pouching time, patient mobility and comfort, odor management, pouch flexibility, adhesiveness, and erosion. A health economic assessment was also done.
  
  
  METHODS
  Twenty-two patients (5 males and 17 females) with an abdominal fistula participated in the study. Participants tested 75 pouches, representing an average of 3.4 pouches per subject. The investigator at each site who performed the pouch changes completed a questionnaire at baseline, during the test, and after testing the pouches. Participants also completed a set of questions after each test pouch was removed.
  
  
  RESULTS
  In 21 of 22 cases, the nurses would consider using the new system on future patients. After each pouch removal, patients were asked whether they were able to move around while wearing the test pouch and they answered yes 95% of the time. The new system was found to have significantly longer wear time than traditional systems (P = .003), but the average time spent on changing the pouches was not significantly different (P = .07). Access for fistula and wound care was rated as excellent in the new pouching system, and comfort was rated as very good.
  
  
  CONCLUSIONS
  The results of the study suggest that all of the key requests received from nurses for an improved system for fistula and wound management were met by the new system.
authors.affiliation: Department of Colon and Rectal Surgery, The Cleveland Clinic Foundation, 9500 Euclid Ave NA-40, Cleveland, OH 44195, USA. Hocevab1@ccf.org; b.hocevar@sbcglobal.net
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Hocevar
authors.forename: Paula
authors.initials: P
authors.lastname: Erwin-Toth
authors.forename: Judy
authors.initials: J
authors.lastname: Landis-Erdman
authors.forename: James S
authors.initials: JS
authors.lastname: Wu
authors.forename: Ann
authors.initials: A
authors.lastname: Navage
authors.forename: Ellen
authors.initials: E
authors.lastname: Duell
authors.forename: Shirley
authors.initials: S
authors.lastname: Dunbar
authors.forename: Anne
authors.initials: A
authors.lastname: Barnard
authors.forename: Catherine
authors.initials: C
authors.lastname: Skinner
authors.forename: Diana
authors.initials: D
authors.lastname: Anderson
authors.forename: George Thomas
authors.initials: GT
authors.lastname: Shires
authors.forename: Lea
authors.initials: L
authors.lastname: Hietala
authors.forename: Sandra
authors.initials: S
authors.lastname: Griffin
authors.forename: Cindy
authors.initials: C
authors.lastname: Owens
authors.forename: Cheryl
authors.initials: C
authors.lastname: Lynch
authors.forename: Susan
authors.initials: S
authors.lastname: Snyder
mesh_terms: D000005:Abdomen; D039021:Colonic Pouches; D016154:Digestive System Fistula / Q000451:nursing*; D005260:Female; D006801:Humans; D008297:Male; D010030:Ostomy / Q000451:nursing; D017592:Skin Care / Q000451:nursing; D014945:Wound Healing