Novel Techniques Using Negative Pressure Wound Therapy for the Management of Wounds With Enterocutaneous Fistulas in a Long-term Acute Care Facility

Abstract

Patient status and wound condition are important factors to consider when developing an appropriate wound management plan. Comorbid conditions such as diabetes mellitus, obesity, and peripheral vascular disease affect wound healing, as do complications, such as fistulas and infections. This article describes 3 novel techniques, using negative pressure wound therapy with reticulated open-cell foam for managing patients with wounds containing an enterocutaneous fistula.

Moisture-Associated Skin Damage

“…17 A common but major challenge in treating a wound with an enterocutaneous fistula pertains to containment of the effluent and protection of the perifistula skin. 18 Once the perifistula skin becomes eroded and moist, the adherence of containment systems becomes more complex, and the predictability of their wear times less certain. This process can result in a cycle of worsening irritant contact dermatitis and an increased risk of additional complications including infection.…”

“…A fistula is an epithelialized passage between 2 or more epithelialized surfaces creating an abnormal communication between one body cavity or organ and another hollow organ or the skin 17. A common but major challenge in treating a wound with an enterocutaneous fistula pertains to containment of the effluent and protection of the perifistula skin 18. Once the perifistula skin becomes eroded and moist, the adherence of containment systems becomes more complex, and the predictability of their wear times less certain.…”