VAC- Problems

MikeRN1 · Nov 9, 2005

but thats probably because its late here and I've been working too much overtime. Usually for fistulas we don't use a vac for the reasons you mention (excessive drainage, leaks, multiple changing, etc.). We use an ostomy appliance which seems to handle the drainage better and reduces skin irritation. But if that is not an option, here are a few things I've seen and used. #1 stoma paste around the fistula, this seems to keep a seal better. #2 Duoderm on the healthy skin around the fistula, this decreases skin irritation and also keeps a seal better. And last but not least #3, Your KCI rep, KCI has either introduced or plans to introduce a bigger canister and you would honestly be suprised what reps keep in the trunks of their cars, they may just have one. Lemme know if this helped at all.

Mike

SWRN84 · Nov 15, 2005

I was actually going to say what Mike said.....duoderm around the irritated skin....although that won't help with the leakage, etc. My best suggestion would also be have the KCI rep come out and take a look. They can give great suggestions if the vac is the best option for this patient. I work in home care and they have come up with great ideas for us.

wocnnurse · Jan 4, 2006

Vac's on a fistula?

I agree with Mike, we usually use an ostomy appliance on fistulas. I remember one case we used a urostomy bag and had to connect it to a foley cath bag becuse of the large amount of drainage it was putting out. And when the patient was up, we connected it to a leg bag. Drainage from the small intestine is very irritating to the skin, stomahesive paste around the appliance and duoderm on the surrounding skin usually helps.