A Chance to Heal Enteroatmospheric Fistula and Improve Patient’s Quality of Life

Problem: Will the use of a collapsible enteroatmospheric fistula (EAF) isolation device reduce patients wound dimension and periwound irritation?

Intervention: Utilization of a collapsible EAF isolation device with negative pressure wound therapy (NPWT) and ostomy pouch to decrease wound dimension and improve periwound skin.

Comparison: Staff managing EAF with gauze packing and ABD pad or an ostomy pouch that needs to be changed more than twice a day resulting to periwound irritation.

Outcome: Decrease wound dimension and improve/intact periwound skin.

The team analyzed three cases of patients who developed an EAF around the area of their ostomy, which resulted in significant mucocutaneous separation around their stoma and severe periwound irritation from a high output acidic effluent.

Result: There is an average healing rate of 69% for the three patients observed. The healing rate observed for the first patient had 78.2% in a month’s time, second patient with 98% in one month time, and the third patient had 39% in two weeks’ time. The collapsible EAF isolation device was used to isolate the patient’s effluent while using the NPWT to granulate dehisce surgical wound surrounding the ostomy. Effluent coming from the ostomy was contained using an ostomy pouch. The periwound skin of all three patients change from severe to mild irritation and eventually became clear. This has greatly improved patient’s quality of life. Two of the patient went on to have a vacation away from their home and one is still recuperating.

Conclusion: The use of a collapsible EAF fistula isolation device is one resource to reduce the patient’s wound dimension and improve healing rate. It also helps restore patient’s periwound skin. The collapsible EAF fistula isolator device should be used in conjunction with nutritional support and provider’s medical management of patient’s medical condition to improve patient’s quality of life.