Fistula Focus: Practical NPWT Application Tips for Managing Fistulas

Speaker: Mary Anne R. Obst, BSN, RN, CCRN, CWON

A fistula is a connection between two organs that are not normally connected, such as the stomach and the skin. Fistulas develop in various conditions and for a multitude of reasons, such as malignancy, Crohn’s disease, colitis, and among others. Many times, fistulas occur after a surgical procedure.

Goals of a care plan around a fistula focus on protection of the skin adjacent, containment of the effluent, nutrition, conditioning and quality of life.
Application of negative pressure wound therapy (NPWT) around a fistula may be considered for managing intestinal fistulas in open abdominal wounds. Goals should include improved wound healing and formation of the fistula stoma, followed by surgical treatment. Appropriate application and technique of NPWT used in fistulas are paramount in overall management.

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