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Fistula Isolation and the Use of Negative Pressure to Promote Wound Healing

A Case Study

Reider, Kersten E.

Journal of Wound Ostomy & Continence Nursing: May/June 2017 - Volume 44 - Issue 3 - p 293–298
doi: 10.1097/WON.0000000000000329
Challenges in Practice

BACKGROUND: A 54-year-old morbidly obese woman with a small bowel obstruction and large ventral hernia was admitted to hospital. She underwent an exploratory laparotomy, lysis of adhesions, and ventral hernia repair with mesh placement. She subsequently developed an enteroatmospheric fistula; several months of hospital care was required to effectively manage the wound and contain effluent from the fistula.

METHODS: Several approaches were used to manage output from the fistula during her hospital course. She was initially discharged to a skilled nursing facility where a fistula management pouch was used for several months to encompass the wound and contain effluent, but this method ultimately proved ineffective. The fistula was then isolated using a collapsible enteroatmospheric fistula isolation device and an ostomy appliance to contain effluent.

CONCLUSION: The application of the collapsible enteroatmospheric fistula isolation and effluent containment devices in conjunction with negative-pressure wound therapy produced positive patient outcomes; it improved patient satisfaction with fistula management, promoted wound healing, and diminished cost.

Kersten E. Reider, RN, BSN, CWOCN, WOC Nurse, Reading Health System, West Reading, Pennsylvania.

Correspondence: Kersten E. Reider, RN, BSN, CWOCN, WOC Nurse, Reading Health System, 6th Ave and Spruce St, West Reading, PA 19611 (

Kersten Reider is a consultant for Acelity

© 2017 by the Wound, Ostomy and Continence Nurses Society.