Insights

Fistula Solution Receives 2026 AAST Best Device Award

Fistula Solution was honored to receive the 2026 AAST Best Device Award at the 85th Annual Meeting of the American Association for the Surgery of Trauma in Dallas.

The award was presented by AAST President Dr. Kimberly Davis during the conference.

Throughout the meeting, the Fistula Solution team had the opportunity to connect with trauma and acute care surgery professionals, demonstrate Fistula Solution devices, and discuss the challenges clinicians encounter in complex fistula care.

The 2026 AAST Best Device Award

The award recognizes the work behind devices developed to support clinicians managing complex fistulas and wounds.

Thank you to Dr. Davis and the American Association for the Surgery of Trauma for the recognition, and to everyone who stopped by the Fistula Solution booth throughout the conference.

F.R.I.E.N.D.S. Mnemonic for Fistula Management

The F.R.I.E.N.D.S. mnemonic for fistula provides a framework for identifying factors that may affect healing in complex fistula cases:

  • F – Foreign body
  • R – Radiation
  • I – Infection or inflammation
  • E – Epithelialization
  • N – Neoplasm
  • D – Distal obstruction
  • S – Steroids

Applying F.R.I.E.N.D.S. to Fistula Management

Identifying factors that may affect healing is one part of managing a complex fistula. Clinicians must also consider the characteristics of the fistula, drainage, surrounding skin condition, and the ability to maintain effective containment.

These considerations can help guide strategies for isolating enteric effluent, protecting surrounding tissue, and maintaining a dependable seal.

The Wound Crown, Fistula Funnel, and Isolator Strip were developed to support different isolation and containment challenges in complex fistula management.

Using the F.R.I.E.N.D.S. framework alongside assessment of the wound and its management challenges can help support clinical decision making throughout fistula care.

When Perifistular Skin Complications Make Maintaining a Seal More Difficult

Perifistular skin complications can create an ongoing challenge in complex fistula management. Once surrounding skin becomes irritated or compromised, maintaining a dependable seal may become increasingly difficult.

When Skin Breakdown Affects Seal Reliability

Difficulty maintaining a seal can lead to further leakage and continued exposure of the surrounding skin. This can create a cycle where compromised skin makes containment more difficult, while continued leakage makes protecting the skin more challenging.

Improving isolation around the fistula may help interrupt this cycle. The Isolator Strip was developed to help create separation between drainage and surrounding tissue, supporting skin protection while helping clinicians maintain a more dependable seal.

When perifistular skin is already compromised, addressing isolation as part of the management strategy may help support both skin integrity and more consistent containment.

Managing Succus Drainage in Complex Fistula Care

Managing Succus Drainage in Complex Fistulas

While a traditional wound manager may be effective in many situations, succus drainage can present challenges that make maintaining a dependable seal increasingly difficult. High-volume output and continuous flow increase the risk of leakage, making consistent wound management more challenging.

When leakage occurs, surrounding tissue can become compromised, making it harder to maintain an effective seal and manage enteric effluent. In these situations, improving isolation around the fistula becomes an important part of the overall management strategy.

The Wound Crown was developed to help address these difficult scenarios. By assisting with separation between the fistula opening and the surrounding wound, it can help isolate enteric effluent, improve seal reliability, and protect surrounding tissue in complex cases.

When succus drainage makes maintaining a dependable seal difficult, improving isolation can help support more consistent wound management while protecting surrounding tissue throughout treatment.

Protecting Perifistular Skin During Feculent Drainage Management

Persistent leakage from feculent drainage can quickly become one of the most frustrating challenges in complex fistula management. Once drainage reaches the surrounding skin, irritation and breakdown can occur, making it increasingly difficult to maintain an effective seal.

As the skin becomes compromised, clinicians are often faced with a cycle of repeated leakage, frequent pouch or dressing changes, and continued skin damage. Breaking that cycle starts with protecting the periwound skin and improving isolation around the fistula.

One approach is to create better separation between drainage and healthy tissue. The Isolator Strip was developed to help support that goal by assisting with isolation around the fistula, helping protect surrounding skin, and supporting a more dependable seal in difficult cases.

Every patient presents unique challenges, and no single solution is appropriate for every situation. When persistent leakage begins to compromise surrounding skin, considering additional isolation strategies may help support more consistent wound management and preserve skin integrity throughout treatment.

When a Traditional Wound Manager Isn’t Enough for Complex Fistulas

Traditional wound managers work well in many situations, but some fistulas present challenges that make maintaining a reliable seal difficult. Irregular wound contours, high-volume drainage, and persistent leakage can quickly lead to skin breakdown and frequent dressing changes.

When these challenges occur, clinicians often need to look beyond repeated adjustments to the same management approach. The focus shifts to protecting the surrounding skin, isolating enteric effluent, and maintaining a more dependable seal that supports ongoing wound care.

The Wound Crown was developed for these difficult situations. By helping separate the fistula opening from the surrounding wound, it can assist with effluent isolation, improve seal reliability, and help protect periwound skin. This allows clinicians to adapt their management strategy when traditional wound managers are no longer meeting the needs of the wound.

No single solution is appropriate for every patient, but recognizing when it is time to consider a different approach can make managing complex fistulas more effective for both the care team and the patient. Understanding how to contain succus drainage can also help guide clinical decision making.

When Anatomy Makes Pouching Difficult

Pouching remains the standard approach for managing ostomies and fistulas. However, certain anatomical presentations can make achieving and maintaining a reliable seal difficult.

Challenges That May Impact Pouching Success

Factors that may contribute to pouching difficulties include:

  • Injured peristomal or perifistula skin
  • Retracted stomas or fistulas
  • Irregular wound contours
  • High-volume effluent
  • Frequent leakage

These challenges can increase dressing changes, contribute to skin breakdown, and make containment more difficult.

When to Consider a New Approach

Early indicators may include:

  • Recurrent leakage
  • Persistent skin breakdown
  • Difficulty maintaining a seal
  • Frequent appliance changes
  • Increasing time spent managing output

Recognizing these challenges may help support an improved management approach.

Isolation Devices are Designed to Assist in Successful Pouching

By separating effluent from vulnerable tissue and directing output into a pouch, isolation devices can help clinicians manage cases where anatomy makes containment difficult.

Clinicians managing these challenges may also be interested in our article, When Pouching Reaches Its Limit: A Surgical Perspective.

For More Information

For information on device availability within your hospital system or to discuss clinical coordination, contact Fistula Solution at info@fistulasolution.com.

Learn more about the Wound Crown®, Fistula Funnel®, and Isolator Strip® in the Knowledge Center.

When Pouching Reaches Its Limit: A Surgical Perspective

Pouching remains the standard for ostomy and fistula management. However, in complex abdominal cases—particularly with open wounds, retracted stoma, or high-output fistulas—pouching alone may not provide reliable protection.

In these scenarios, isolation devices serve as a critical adjunct, enabling effluent to be controlled and consistently directed into a pouch.

Why Pouching Fails

Pouching challenges are typically driven by:

  • Open peristomal wounds
  • Retraction or difficult fistula/stoma site
  • High-volume effluent

These factors can compromise adhesion, leading to leakage and frequent appliance failure.

Recognizing When there is a Need

A change in strategy should be considered when:

  • Leakage interferes with wound healing or patient mobility and quality of life
  • Dressing and pouch changes become frequent and/or resource-intensive
  • Peristomal or periwound breakdown persists

These challenges are often due to a dressing limitation, not a technique issue.

Isolation as an Adjunct to Assist in Pouching

Isolation devices are not an alternative to pouching—they are a tool to make pouching viable in hostile environments.

They function to:

  • Physically separate effluent from vulnerable tissue
  • Create a controlled channel directing output into the pouch
  • Protect surrounding tissue to support healing

Where Fistula Solution Fits

Fistula Solution devices, including the Wound Crown®, are designed to assist in successful pouching.

They provide a structured method to isolate effluent and direct it into a pouch, helping restore control in difficult-to-manage cases and supporting surgical and wound care objectives.

For More Information

Want to learn more? For information on device availability within your hospital system or to discuss clinical coordination, contact Fistula Solution at info@fistulasolution.com.

WOCNext 2026 | Fistula Care, Effluent Control & Skin ProtectionBooth 1107

Join Fistula Solution Corporation at WOCNext 2026 to connect with WOC nurses managing complex fistula and ostomy patients.

Let’s talk about what matters at the bedside:

  • Controlling high-output fistulas and preventing leaks
  • Protecting periwound and peristomal skin in challenging anatomy
  • Simplifying pouching in patients with irregular surfaces
  • Supporting patients transitioning from complex wounds to manageable ostomies

Spotlight: GRIFF Collaborative
Learn about GRIFF Collaborative—a growing international effort focused on improving outcomes in intestinal failure and fistula care.
Explore more: https://griffcollaborative.org/

WOCNext sessions to consider:

ASCRS 2026 | Managing Complex Fistula and Ostomy Patients Booth 805

Join Fistula Solution at ASCRS 2026 to discuss practical strategies for stabilizing and managing complex abdominal patients, including complex fistula management and ostomy care.

Topics for discussion:

• Enteric fistula isolation to control effluent and protect the wound field
• Management of high-output and anatomically challenging ostomies
• Anal isolation as a potential alternative to diversion in select cases
• Techniques to maintain skin integrity and enable reconstruction

Featured Surgical Approach: RISP

Revise
Isolate
Skin Graft
Pouch

A staged approach designed to reconstruct peristomal or peri-fistula soft tissue and support transition to a durable, manageable ostomy or fistula.