Techniques: Surgical Reconstruction of Peri-fistula/stomal Soft Tissue: Revise, Isolate, Skin Graft, Pouch (RISP)
Click here to download the RISP poster presentation from SAWC Fall 2021. In some situations, the soft tissue around a fistula or ostomy makes it impossible to apply a pouch and contain effluent. The purpose of RISP (Revise, Isolate, Skin graft, Pouch) is to transition the patient to a standard, easy-to-apply ostomy appliance.
Perineal Wound Management
Literature: New Technique to Protect Perineal Skin Grafts Without A Diverting Ostomy (2021)
Feeding Fistula Patients
Literature: A Patient's Guide to Managing a Short Bowel (2016)
Request a complimentary copy of A Patient's Guide to Managing a Short Bowel by Carol Rees Parrish MS, RDN.
Enteric fistula patients frequently suffer from chronic malabsorption due to Short Bowel Syndrome (SBS). Carol's book is the seminal guide for managing SBS so that fistula patients get proper nutritional support.
Literature: The Art of Fistuloclysis: Nutritional Management of Enterocutaneous Fistulas (2010)
Tools: Short-Bowel Syndrome Medication Protocol Example for Antimotility Medications
Webinar: Slow Down: Management of the High Output Ileostomy (2020)
Webinar: Entero-cutaneous and entero-atmospheric fistulas: Have we had a paradigm shift in management? (2019)
Click here to view this webinar from the American Association for the Surgery of Trauma. Dr. Richard Miller, Chief, Division of Trauma and Surgical Critical Care at Vanderbilt Medical Center presents a comprehensive overview of enteric fistula management and makes a strong case for "feeding the gut". The webinar is part of the AAST Virtual Grand Rounds educational program.
Webinars and Videos
Webinar: 2-part Series on Fistula Care (2020)
View the on-demand series on fistula care from the 2020 Northeast Region of the WOCN's virtual conference:
Webinar: Fistula Management YouTube Video Series (2020)
View this free video series on enteric fistulas, management techniques, and application of Fistula Solution devices in patient treatment by clicking the chapters below:
Webinar: Reimagine Solutions for Fistula Management: The Patient, The Fistula, The Skin! (2020)
Techniques: Isolation of Enteric Fistulas to Allow Adjacent Skin Graft Placement
This downloadable case study poster from SAWC 2020 Virtual illustrates a new technique to manage intestinal effluent during the placement of skin grafts or artificial skin substitutes onto nearby wounds. Skin grafting around enteric fistulas and ostomies may allow providers to transition patients to standard ostomy appliances.
You may also click here to hear the poster presentation.
Techniques: Application of an Elastomeric Skin Protectant in Periwound Care and the Use of Customizable Isolation Devices for Fistula Management
View the poster presentation Evaluating the Application of an Elastomeric, Advanced Skin Protectant in Periwound Care and the Use of Customizable Isolation Devices for Fistula Management from 2021 WoundCon Summer. In the cases presented, modalities for fistula isolation and stoma management were integral to recovery with special attention toward periwound care.
Techniques: Belted Ostomy Pouch with Fistula Solution Devices for Difficult Perifistula
Using a belted ostomy pouch with Fistula Solution devices can be a good effluent management option in cases when perifistula creases or scars make adhesive pouching difficult or when ostomy pouches will not adhere to denuded and weeping peristomal skin. Visit our "how-to" post.
Techniques: Contain High-output Fistula and Ostomy Effluent
Techniques: Stabilize PEG Tubes and Wound Drains with the Fistula Funnel to Reduce Insertion Site Leakage
Gastric fluid leakage or wound drainage around around medical tubes can cause skin irritation, infection, reduced healing times, and general patient discomfort. The Fistula Funnel can be used to stabilize tubes to reduce tube pressure on the insertion site and the resulting leakage. Visit our "how-to" post.
Literature: New Compressible Barrier Devices for Enteric Fistula and Ostomy Effluent Isolation (2020)
Literature: Atlas of Critical Care Procedures (2018)
Find excellent guidance on the Local Management of Enteroatmospheric Fistulae in Chapter 34 of the Atlas of Critical Care Procedures, Editors: Demetrios Demetriades, Kenji Inaba, and Philip D. Lumb.
This atlas is a standard reference for surgeons, critical care physicians, nurses and all critical care professionals who manage enteric fistulas and complex wounds.
Literature: Collapsible Enteroatmospheric Fistula Isolation Device: A Novel, Simple Solution to a Complex Problem (2015)
Literature: Novel technique for stomal isolation after extensive abdominal wall soft tissue loss (2018)
Literature: Fistula Isolation and the Use of Negative Pressure to Promote Wound Healing (2017)
Literature: SNAP protocol for fistula care (Skin and Sepsis, Nutrition, definition of fistula Anatomy, and proposing a Procedure to address the fistula)
Literature: Management of enteroatmospheric fistula with negative pressure wound therapy in open abdomen treatment: a multicentre observational study (2016)
Literature: Enterocutaneous fistula after emergency general surgery: Mortality, readmission, and financial burden (2020)
Literature: Long-Term Teduglutide for the Treatment of Patients With Intestinal Failure Associated With Short Bowel Syndrome (2016)
Tools: CeDAR App
Download the free CeDAR app to facilitate conversations with patients about their fistula repair surgery risk profile. Users simply answer eight questions about themselves, including height and weight. A percentage chance of developing specific postoperative complications requiring treatment is calculated, along with the corresponding cost of this treatment. These results can then be used to discuss a patient’s risk for wound problems after surgery and what changes they can make to improve the odds for a good result.
Inventing a New Device?
University of Minnesota Value Proposition Design Online
This free program earns participants a Certificate in Value Proposition Design from the Holmes Center for Entrepreneurship at the University of Minnesota. Participants utilize Lean Startup tools and receive feedback from instructors deeply experienced in science/technology entrepreneurship. In addition, industry experts and entrepreneur mentors offer insights, advice and connections.
gBETA Medtech is a free, seven-week accelerator that works with medical device, healthcare-related software, biotech and diagnostics startups. Each program is capped at five teams, and requires no fees and no equity.
3M Submit Your Idea
As a leader in applying science to life to provide innovative products and technologies, 3M actively pursues open innovation opportunities. This form asks for your contact information, your patented idea and for information concerning your granted or issued patent.
Video: The Frank & Lizzie Show (2021)
Watch the pilot episode of The Frank & Lizzie Show highlighting the development of Fistula Solution devices. This morning talk-show style channel features clinicians and products within the wound care community.