Management of fistulae in the abdominal region.
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.
Hocevar
Barbara J
BJ
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
Erwin-Toth
Paula
P
Landis-Erdman
Judy
J
Wu
James S
JS
Navage
Ann
A
Duell
Ellen
E
Dunbar
Shirley
S
Barnard
Anne
A
Skinner
Catherine
C
Anderson
Diana
D
Shires
George Thomas
GT
Hietala
Lea
L
Griffin
Sandra
S
Owens
Cindy
C
Lynch
Cheryl
C
Snyder
Susan
S
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