Fistula Focus: Practical Application Tips for Managing Fistulas

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By Mary Anne R. Obst, BSN, RN, CCRN, CWON

A fistula is a connection between two organs that are not normally connected, such as the stomach and the skin. Fistulas develop in various conditions and for a multitude of reasons, such as malignancy, Crohn’s disease, colitis, and others. Many times, fistulas occur after a surgical procedure. Goals of a care plan around a fistula focus on protection of the adjacent skin, containment of the effluent, nutrition, conditioning, and quality of life.

Application of negative pressure wound therapy (NPWT) with fistula isolation may be considered for managing intestinal fistulas in an abdominal wound. Goals should include improved wound healing around the fistula stoma, which can be followed by surgical treatment to improve quality of life. Appropriate application and technique of NPWT used in fistulas are paramount in overall management.

Pouching is not always straightforward. Utilizing a combination of wound healing and ostomy pouching skills will help manage the effluent from the fistula and bring better overall health to the patient.

Fistula management can be frustrating for both the patient and the clinician. Creating a plan of care that optimizes quality of life by containing effluent, managing nutrition, and providing conditioning will help to encourage best outcomes for the patient.

See You at WoundCon Fall

I’ll be talking about fistulas at WoundCon Fall 2021, so if you like to talk about fistula patients, or if you dread fistula patients, maybe you could join me. Let’s really think about the word fistula and break it down. F stands for fistula fun Fridays, and that just happens to be the day that WoundCon Fall 2021 is on, on a Friday. I stands for instructional tips and trips for fistula management, and that just happens to be what we’re really going to talk about in this lecture. S stands for a streamlined approach. You really need to have a protocol, a streamlined approach in fistula management, to have the best outcomes for your fistula patients. T stands for teamwork. You absolutely need a team to take care of these patients. You just can’t go it alone. U stands for all of you. If you come to WoundCon Fall 2021, we’ll be talking about fistulas. L stands for my absolute love of fistulas, and I hope that I can help you to love them, too. A stands for all are welcome. WoundCon 2021 is an amazingly simple way to get great education. So please join me for my presentation, “Fistula Focus: Practical Application Tips for Managing Fistulas,” at WoundCon Fall on November 12th at 5:30 PM Eastern Standard Time. Registration for WoundCon Fall 2021 is open now and is free for health care professionals, who can earn CME credits by attending.

Register for free at www.woundcon.com.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.

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  • October 26th, 2021

    A fistula is a connection between two organs that are not normally connected, such as the stomach and the skin. Fistulas develop in various conditions and for a multitude of reasons, such as malignancy, Crohn’s disease, colitis, and others. Many times, fistulas occur after a surgical procedure....

  • August 11th, 2020

    Holly M. Hovan MSN, RN-BC, APRN, CWOCN-AP

    Negative pressure wound therapy (NPWT) is an advanced wound care modality using a sponge with an occlusive dressing connected to a pump that creates a negative pressure environment to promote wound healing. NPWT has many indications and...

  • October 29th, 2020

    By: Dianne Rudolph, DNP, GNP-BC, CWOCN

    What are some ways to achieve insurance coverage for fistula pouches or to use ostomy supplies for a fistula? We often run into the issue of supplies not being covered for Medicare or Medicaid patients.

    Unfortunately...

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