An accountable fistula management treatment plan

Abstract

An accountable fistula management treatment plan focuses on combining effective medical and nursing treatment with effective and efficient pouching technique and equipment to ensure patient comfort. Small bowel fistula following abdominal surgery can provide challenges in patients' medical and nursing management. This article describes a case study of the successful medical and nursing management of a patient post-abdominal surgery. Within days of surgery a small bowel fistula formed within an abdominal wound. Medical management involved the use of total parenteral nutrition, electrolyte balance management, nil orally and Sandostatin medication. The nursing interventions comprised accurate intake and output measurement, effective and efficient pouching systems and appropriate psychological care. The medical and nursing interventions provided during the healing process are outlined together with the assessment and evaluation of a new innovative wound management pouch. This system proved invaluable in the successful containment of a high small bowel effluent and skin preservation. In an attempt to share best practice a pictorial guide is provided to demonstrate the correct application of the pouching system and technique. This article provides details of an accountable fistula management treatment plan which resulted in the successful spontaneous closure of the small bowel fistula coupled with excellent cost-effectiveness and patient comfort.

Case Report: Enterocutanic Fistle

“…The lesions (ulcers) are in constant contact with each other and are separated by normal tissue. [6][7] In advanced cases, the intestinal mucosa thickens and becomes fibrotic and eventually the intestinal lumen narrows. Localized effects of intestinal fluids can be damaging or corrosive to non-intestinal tissues, causing damage, erosion, and loss of normal organ or organ system function.…”

“…Understanding the pathophysiology and risk factors as well as appropriate treatment can help reduce the occurrence of enterocutaneous fistulas. [6][7][8][9]…”