Tag: Fistula isolation

Fistula Management Takes a Team

Effective fistula and complex ostomy management depends on a coordinated, multidisciplinary approach. Surgeons, wound and ostomy nurses, dietitians, bedside staff—and the patient and family—all play a critical role. When these groups share a common management plan care becomes more consistent and effective.

Where Opportunities Exist

Awareness and familiarity can vary across teams. One clinician may recognize the need for isolation, while another may choose a different approach. Aligning awareness across the care team can help reduce variability and support better outcomes.

Why Team Alignment Matters

When care teams are aligned patients benefit:

  • More predictable dressing changes
  • Improved wear time
  • Better protection of periwound skin
  • Quality of life

Supporting the Team

Fistula Solution devices are designed to support isolation in complex cases where standard methods may be difficult to maintain. For example, the Wound Crown® may be helpful in:

  • Fistula in a wound bed
  • Retracted or sidewall fistulas
  • Irregular abdominal contours
  • Protection of skin grafts

These tools are intended to support team coordination—helping clinicians manage effluent, protect skin, and deliver more consistent care.

Learn More

For more information on device availability contact: info@fistulasolution.com

Surgical Tissue Revision Around Stomas: Why Effluent Control Matters

When a fistula or ostomy becomes “unpouchable,” consider soft tissue revision followed by management with a fistula isolation device.

Open wounds, uneven or scarred tissue, retracted stomas, and fistulas under wound edges can make reliable pouching impossible. Recurrent leakage leads to maceration, prolonged hospitalization, and patient frustration.

This is where RISP provides structure.

What Is RISP?

RISP stands for:

Revise. Isolate. Skin Graft. Pouch.

It is a staged surgical technique designed to reconstruct peri-stomal or peri-fistula soft tissue and ultimately transition the patient to a standard, easy-to-manage ostomy appliance.

The sequence matters:

1. Revise

Surgically revise soft tissue to fully expose the stoma or fistula and create a viable pouching surface (without entering the peritoneum).

2. Isolate

Control and divert effluent using isolation devices and negative pressure wound therapy (NPWT) to heal the wound.

3. Skin Graft

Place a skin graft around the stoma or fistula once output is controlled. Protect the graft with continued isolation and NPWT support.

4. Pouch

Transition to a standard ostomy appliance once the graft has healed, restoring independence and reliability.

Why Isolation Is Central

Isolation is the turning point in RISP. Effluent control creates the conditions necessary for graft survival and predictable reconstruction.

RISP highlights the importance of multidisciplinary collaboration and environmental control in complex abdominal reconstruction.

For a visual demonstration of the RISP technique, watch this video:
https://youtu.be/c8ojt1zck-c

For additional information about RISP or isolation strategies in complex fistula cases, contact Fistula Solution.