High-output Fistula and Ostomy Effluent Containment

Managing effluent from a high-output fistula or ostomy can be a challenge.  Even large, high-output pouches can prove insufficient when a patient puts out 5 to 10 (or more) liters of effluent daily.

Pictured is a technique for managing high volumes of effluent.  A container is connected to the pouch using large bore corrugated tubing.  Then, as prescribed by the provider, intermittent wall suction is applied to the container to draw effluent out of the pouch.

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1. Connect and seal a suction tube near the top of a 3000 ml or other large container.  Do not extend the tube more than 3 inches / 6 cm inside the container.  Connect the free end of the tube to wall suction.

container 1

2. Connect and seal corrugated tubing to the top of the container.  Ensure tubing is long enough to reach from the floor to the patient's pouch.

container 2

3. Fasten the top to the container and place the container on the floor near the patient.

Note that the container inlets for corrugated tubing and wall suction are spaced apart.  This is so the effluent that is drawn into the container will drop to the bottom of the container and not be drawn into wall suction.

container 3

4. Connect and seal the free end of the corrugated tubing to the pouch drain.

As indicated by the healthcare provider, apply intermittent wall suction to draw excess effluent out of the pouch and through the corrugated tubing into the container.

container 4

This technique tip can help eliminate pouch clogs and effluent overfilling that can result in pouch adhesion failure and spills

The fill level of the large container should be monitored and the container can be emptied as needed.  When a patient needs to move the suction tube can be disconnected from the wall so the patient can take the container with them.

Stop Pouch Attachment Leakage

Leaks can happen at the interface of a pouch appliance and Fistula Solution device.  Usually leaks are because the pouch opening is cut too small or because of poor pouch adhesion.

The goal is to direct ALL effluent into the pouch appliance with no leaks.  These technique tips will help assure success.

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Click here for a detailed pouching video that demonstrates these technique tips.

1. Add a thin ostomy barrier ring to the top flange of the of the Fistula Solution device.  This landing zone is where the high output ostomy pouch or wound manager will be placed.

Pouch 1

2. Cut the opening in the high output ostomy pouch or wound manager generously.  Make the opening diameter about 1 cm larger than the Fistula Solution device opening.  Then place the pouch appliance on the landing zone.

Pouch 2

3. Bridge the gap between the opening of the pouch appliance and the landing zone with another ostomy barrier ring.  A barrier ring can be cut and applied in segments as shown in the image to the right.

Work the pouch appliance into the barrier rings. Have the patient lay quietly for 30 minutes or more to allow the pieces to warm up and adhere to each other.

Pouch 3

These technique tips can help stop leaks from happening at the interface of the pouch appliance and Fistula Solution device, and ensure all effluent goes into the pouch where it belongs.