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Executive Summary

Nurses Specialized in Wound, Ostomy and Continence Canada (NSWOCC) Nursing Best Practice Recommendations

Enterocutaneous Fistula and Enteroatmospheric Fistula

Brooke, Jillian; El-Ghaname, Amanda; Napier, Karen; Sommerey, Laureen

Journal of Wound Ostomy & Continence Nursing: July/August 2019 - Volume 46 - Issue 4 - p 306–308
doi: 10.1097/WON.0000000000000555
Ostomy Care

Enterocutaneous fistulas (ECF) and enteroatmospheric fistulas (EAF) pose significant quality-of-life concerns for patients, and management challenges for the interprofessional healthcare team. In 2009, the Canadian Association for Enterostomal The developed best practice recommendations for the management of ECF. Over time, evidence and practice evolve, and the Nurses Specialized in Wound, Ostomy and Continence Canada performed a comprehensive review of the literature and revised the practice recommendation document. The revised recommendations provide evidence-based management guidance for ECF and EAF in the adult population whether in acute care, community/home care, or long-term/residential settings, and are specifically created for nurses. The revised recommendations include organizational support, assessment, nutrition, pharmaceutical management, education, and local fistula management. This article serves as an executive summary for this clinical resource; the full guideline is available at

Jillian Brooke, MClSc-WH, BSc (Hons), RN, WOCC(C), SE Health, Markham, Ontario, Canada.

Amanda El-Ghaname, BScN, RN, WOCC(C), SE Health, Windsor, Ontario, Canada.

Karen Napier, MClSc-WH, BScN, RN, WOCC(C), Sturgeon Community Hospital, Alberta Health Services, St Albert, Alberta, Canada.

Laureen Sommerey, MScN, RN, WOCC(C), Interior Health Authority, Kelowna, British Columbia, Canada.

Correspondence: Jillian Brooke, MClSc-WH, BSc (Hons), RN, WOCC(C), SE Health, 90 Allstate Pkwy, Ste 300, Markham, ON L3R 5H3, Canada (

The authors declare no conflicts of interest.

© 2019 by the Wound, Ostomy and Continence Nurses Society.