Insights – Page 5 – Fistula Solution

Free Webinar on Comprehensive Management of Digestive Tract Fistulas

Mary Anne Obst, RN, CWON, CCRN, presents in this free recorded webinar that will increase your knowledge of enteric fistulas and their management. This informative program will give you practical insights into assessing the patient with an enteric fistula. Mary Anne will also cover the medical, surgical, and wound care strategies that can help optimize patient outcomes.

Click here to view the webinar.

Sharing her clinical expertise as a complex abdomen specialist, Ms. Obst will outline the risk factors associated with enteric fistulas and the preventive measures that may help reduce complications. Critical factors for successful fistula management and closure will be covered. Mary Anne will also discuss specific wound care principles and the application of the "pinch test" as the gateway to surgical readiness.

Fistula Training with the thumbroll App

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.

For more information:

facebook.com/thumbrollmed
instagram.com/thumbroll
youtube.com/c/thumbrollmedical

Protect Perineal Burns and Wounds without a Diverting Ostomy

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 here to 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.

Stabilize PEG Tubes and Wound Drains to Reduce Insertion Site Leakage

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.

Washington D.C. Symposium: Innovative Options for Complex Wounds and Fistula Management

KCI An Acelity Company is sponsoring a breakfast symposium focusing on: “New Advances in Challenging Wound Care: Examining the Evidence and Discussing the Cases” at the Abdominal Wall Reconstruction Conference in Washington D.C. on June 8th. The session features presentations on new therapies from Vedra Augenstein, MD, Luis Fernandez, MD, and Mary Anne Obst, RN.

This presentation begins at 8:30 AM on June 8th at the Grand Hyatt Washington.

Florida Enteric Fistula Management Hands-on Workshop

Kersten Reider BSN, RN, CWOCN, will be conducting a hands-on enteric fistula management workshop at the 2019 Florida Association of Enterostomal Therapists Conference in Gainsville, Florida. The workshop begins at 4:30 PM on Friday, May 31st in the Hilton University of Florida Conference Center.

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.

SAWC Spring 2019 – Surviving an Enteric Fistula: The Reality for the Patient and Care Providers

Mary Anne Obst, Complex Abdomen Specialist at Regions Hospital in St. Paul, Minnesota, will present “Surviving an Enteric Fistula: The Reality for the Patient and Care Providers” at SAWC Spring 2019. The presentation is Session 22 on May 9th at 9:15 AM.

Mary Anne will discuss the life changing physical and emotional trauma that some patients experience when a fistula develops. The leakage, odor and skin destruction, and depression can lead to physical and emotional pain that is unbearable. Caregivers suffer as well in terms of frustration with management problems and inability to “make it better” for the patient with the condition. This session will demonstrate pouching techniques using negative pressure wound therapy to contain the drainage, skin management to reduce the discomfort, and pouching tips for keeping the patient clean, dry, and comfortable during this trying time.

Visit the SAWC Spring 2019 website to see the full conference agenda.

Challenging Scenarios and Fistulas at the AWR Conference

The Challenging Scenarios session at the upcoming Abdominal Wall Reconstruction Conference includes hernia repair topics and a pair of exciting enteric fistula presentations. B. Todd Heniford, MD from Carolinas Medical Center Department of Surgery will present "Mesh Infection and Fistula: Surgical Management and Long-term Outcomes". Dr. Heniford will be followed by Mary Anne Obst, WOCN and Complex Abdomen Specialist at Regions Hospital, who will share "Enterocutaneous Fistula: Best Practices for Wound Management".

The presentations will be followed by questions and panel discussion including best practices in fistula management.

The 2019 Abdominal Wall Reconstruction conference will be June 6-8 at the Grand Hyatt in Washington D.C. Visit the AWR website to see the full conference agenda.