Purpose: Abdominal wound dehiscence proved to be challenging as multiple enterocutaneous fistulas formed in one patient admitted post op to the SICU.  Adhering to evidenced based guidelines, this case study demonstrates innovative solutions that positively affect outcomes in wound care management.   Description:  An ICU RN that is certified in wound care (CWCN) can affect successful outcomes when advanced principles of wound care management are applied. This is done through educating staff, consultation, and wound management.   Mr. D was admitted post operatively to the surgical ICU following ventral hernia repair.  He developed complications of a perforated bowel and dehiscence with the eventual development of multiple fistulas.  Protecting the perifistular skin, containing effluent, controlling odor, ensuring patient comfort, and providing accurate effluent measurement adhered to WOCN guidelines for fistula management.  These goals were accomplished utilizing Negative Pressure Wound Therapy (NPWT), closed suction, and a trough/pouch system.  After the fistulas were stabilized, the patient returned to the OR for a small bowel resection and Alloderm grafting.  Plan of care then changed to Alloderm care and monitoring, utilizing advanced wound care principles to promote optimal closure.   Evaluation/Outcome:  Mr. D's wound has contracted and granulated.  Epithelization is being promoted through knowledge of advanced wound care principles related to wound debridement and hypergranulation resolution.  Advanced fistula/wound care principles haven proven successful in managing this complex wound through its many phases.  The case study demonstrates optimal patient outcomes due to availability of a certified wound care nurse.  E-mail:  lpmeyer@comcast.net