The free thumbroll app has a new step-by-step training module on Enteroatmospheric Fistula Wound Management. Simply download it from the App Store or Google Play and start learning.
The fistula module is in the General Surgery section of the app. thumbroll uses real images to show how to use the Wound Crown in detailed steps, making it easily digestible. Learn at your pace as you scroll through each step of the process.
thumbroll is like a visual checklist. Content is broken down to the component steps, allowing you to just see what is necessary to learn the material.
thumbroll is a free learning tool for all medical trainees and professionals worldwide and it is available for iOS & Android.
A common mitigation approach to fecal contamination of perineal wounds and skin grafts is to create an ileostomy or colostomy. However, the Fistula Funnel can be paired with standard fecal management systems to isolate burns and wounds to the perineum without surgical redirection of the fecal stream.
This illustration depicts how the Fistula Funnel can be employed to isolate a fecal management system. The "how-to" steps to assemble the devices follow.
Click hereto see a video that demonstrates this technique.
1. Tailor the Fistula Funnel and create a skirt by cutting along the scribe line. The skirt is intended to seal and protect the perineum from fecal management system leakage.
2. Disinfect the Fistula Funnel with skin or wound cleaning solution, then pull the fecal management system through the Fistula Funnel opening.
3. Apply dressings to Fistula Funnel, ensuring the skirt around the base of the Fistula Funnel opening faces toward the anus.
4. Apply an ostomy barrier ring to the base of Fistula Funnel to help form a seal between the skin and the device.
Compress the prepared Fistula Funnel against the skin around the fecal management drain to seal and protect the perineum.
Gastric fluid leakage or wound drainage around medical tubes is an unfortunate occurrence. The leaked fluid can cause skin irritation, infection, reduced healing times, and general patient discomfort. Leakage often occurs because patient movement rubs the tube against the insertion site and widens the incision over time
The Fistula Funnel can be used to stabilize tubes and reduce tube friction on the insertion site. The "how-to" steps follow.
1. As shown, place the bottom half of the Fistula Funnel around the tube prior to tube placement if possible.
If the tube is already in place, tailor the Fistula Funnel by cutting as indicated by the dotted line so it can be placed around the tube.
2. Place a contact layer followed by a flat ostomy barrier ring on the perimeter skin. Notch the flange to allow the device to flex, then place it around the tube so that the notched flange rests on the ostomy barrier ring.
3. Fasten the Fistula Funnel to the patient by placing adhesive strips on top of the base flange. Use zip ties or tape to fasten the Fistula Funnel to the tube. The stabilized tube should stand perpendicular to the patient's body.
This technique can stabilize PEG tubes and wound drains in order to reduce tube rubbing on the insertion site and mitigate incision widening. The Fistula Funnel and companion dressings can also help seal and protect the skin from leakage when applied as shown.
Reider notes, “Enteroatmospheric fistulas (EAF) are common complications of open abdomen bowel surgery. An EAF is a devastating complication for both surgeon, clinical provider, and patient. Prior to the advent of sophisticated treatment plans, EAF’s held a large mortality rate. Traditionally, management of EAFs had involved placing large fistula management pouches over the wound to collect and contain effluent. However, at FAET we will be demonstrating more current techniques to isolate and heal fistulas.”.
Kersten is a Wound, Ostomy, Continence Nurse with Tower Health System in West Reading, Pennsylvania. She has extensive experience in managing enteric fistulas and using Fistula Solution devices. Her workshop will teach you new ways to address your fistula challenges.
Visit the FAET website to see the full conference agenda.