Management of complex abdominal wounds with small bowel fistulae: isolation techniques and exudate control to improve outcomes

Enterocutaneous fistulae associated with abdominal surgery are an extremely troublesome complication. Fistulae that occur in large, open abdominal wounds and connect the wound bed and small bowel are especially prone to complications. Although a variety of management suggestions are available on thi...

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Bibliographic Details
Published inJournal of wound, ostomy, and continence nursing Vol. 36; no. 4; p. 396
Main Authors Brindle, C Tod, Blankenship, Jolie
Format Journal Article
LanguageEnglish
Published United States 01.07.2009
Subjects
Aged
Colostomy - adverse effects
Exudates and Transudates
Female
Humans
Intestinal Fistula - pathology
Intestinal Fistula - therapy
Intestine, Small - pathology
Male
Middle Aged
Pancreatitis, Acute Necrotizing - pathology
Patient Care Team
Postoperative Complications - pathology
Treatment Outcome
Wound Healing
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Summary:Enterocutaneous fistulae associated with abdominal surgery are an extremely troublesome complication. Fistulae that occur in large, open abdominal wounds and connect the wound bed and small bowel are especially prone to complications. Although a variety of management suggestions are available on this subject, few standard methods of management are discussed. The primary goals of care are (1) nursing management of fistula output and wound healing and (2) medical management supporting either spontaneous or surgical closure of the fistula. This article presents case studies of patients with small bowel fistulae located in large abdominal wounds and describes approaches for managing high-output enteric effluent (1-6 L daily) while achieving underlying wound healing. These approaches suggest opportunities for further research, new product development, and adjunctive multidisciplinary approaches.
ISSN:1528-3976
DOI:10.1097/WON.0b013e3181aaf2b0