Holly Hovan's picture
fistula management

By Holly Hovan MSN, APRN, CWOCN-AP

A fistula is an abnormal opening between two areas that typically shouldn't be connected, or with an epithelialized tract. An example is an opening from the bowel to the abdominal wall, termed enteroatmospheric or enterocutaneous (the terms are sometimes used interchangeably) because this fistula is exposed to the atmosphere, or is open from the abdomen to the skin, and typically needs to be pouched or some type of containment of the effluent.

Lydia Meyers's picture

By Lydia A Meyers RN, MSN, CWCN

Enterocutaneous Fistulae (ECF) are a major healthcare issue affecting patients, their lives and the healthcare system. ECF are defined as abnormal connections from one organ to another. The most serious condition is formation from an internal organ to the skin. According to an article by Willcutts, Scarano, & Eddins in 2005, 75% to 85% of all fistulas occur 7 to 10 days after surgery. ECF often develop as a result of the patient's medical condition, past radiation treatments in area, and malnutrition of the patient. The names of ECF are related to exit and entrance points. According to Baranoski & Ayello, 2012, the mortality rate for patients with ECF ranges from 12% to 25%. The mortality is the result of sepsis, malnutrition, and dehydration. The ECF patient faces several problems including: cost of supplies, control of exudate and quality of life issues for the patient.