HELP! 7 visits in 1 day for a fistula!!!

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    Hi all. I am an RN for VNA and do alot of wound care and ostomies. We have a patient now that has an abdominal fistula that has been an ongoing source of problem. Due to the high output, we are using an ostomy bag. Problem is she has many "dips and crevices" that inhibit the appliance from sticking. We have tried paste, coloplast strips, eakins and used all of these in various ways ( on her skin, on the wafer..) We have tried a catheter to collect drainage ( occludes) and she has been hooked up to suction ( occludes too). We have tried 6-8 different ostomy systems. The longest we have had anything stay is for about 2-3 days. Earlier this week we had 7 visits in a 24 hour period!!! If anyone has any suggestions I could try I would sincerely appreciate it. Thanks
  2. 3 Comments so far...

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    Quote from banana1
    Hi all. I am an RN for VNA and do alot of wound care and ostomies. We have a patient now that has an abdominal fistula that has been an ongoing source of problem. Due to the high output, we are using an ostomy bag. Problem is she has many "dips and crevices" that inhibit the appliance from sticking. We have tried paste, coloplast strips, eakins and used all of these in various ways ( on her skin, on the wafer..) We have tried a catheter to collect drainage ( occludes) and she has been hooked up to suction ( occludes too). We have tried 6-8 different ostomy systems. The longest we have had anything stay is for about 2-3 days. Earlier this week we had 7 visits in a 24 hour period!!! If anyone has any suggestions I could try I would sincerely appreciate it. Thanks
    Haven't you tried to use a Wound Vac System?? Im not a Wound Nurse, but in Vascular and Diabetic nursing, I have seen alot of different types of wounds. For a draining wound, Wound Vacs have a very high rate of healing
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    Thank you for your input. I am not sure if the VAC would work or not. But, I just found out today that my patient is going to have surgery to hopefully have SOMETHING done. She is a poor surgical risk but stated that she cannot live like this anymore. I hope it works out for her. Thanks again.
  5. 0
    wow... well I am 2 and 1/2 years late on this discussion.... But I got into taking care of fistula because I hate them so much! The are hard and very expensive to care for. over the last three years I have done alot of w/care on them and have a set-up and approach to "close" or "contain" sucessfully. A client that I have been "using as a ginnie pig" (willingly I'll add) we will call her Judy, she has now been home for 14 months, originally there was 3 fistula, one closed in hospital and #2 closed 11/09, we have one left.... would love to talk to other nurses who deal with ABD fistula (others too) and how they currently approach care for this problem and how is it working for you? Better yet, how's your patient? What are some of the challanges you face trying to get a handle on this problem? Thanks


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