New Technique to Protect Perineal Skin Grafts without a Diverting Ostomy at EAST Conference

David Dries, MD will present Massive Burns After Forge Explosion: New Technique to Protect Perineal Skin Grafts without a Diverting Ostomy at 4:06 PM EST on January 14th, 2021 during the Eastern Association for the Surgery of Trauma's Annual Scientific Assembly – Virtual.

One of the difficult aspects of maintaining good wound healing and perineal wounds is fecal contamination. Diverting colostomy and ileostomy are treatment options along with administration of materials which affect bowel motility.

Dr. Dries will present a new technique using a fecal collection circuit combined with an isolation device to avoid redirection of the fecal stream with the associated additional operative procedures of colostomy and ileostomy formation.  This Master Class Surgical Video presentation will illustrate a step-by-step application of this technique through case-study pictures and illustrations.

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.

Fistula Funnel anal isolation

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.

Scribe line

2. Disinfect the Fistula Funnel with skin or wound cleaning solution, then pull the fecal management system through the Fistula Funnel opening.

FMS isolation

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.