Use of a Wicking Strip Dressing with Pouching System to Manage Heavy Exudate from Fistulas and Wounds

Clinical Problem: Heavily exudating fistulas and wounds present a healthcare management problem for clinicians. Patients were managed with an innovative integrated dressing/pouching system. The first patient had a biliary fistula with heavy caustic bile drainage, patient two a moderate draining cutaneous fistula and patient three a highly draining abdominal abscess.

Past Management: Patients one and two were managed with gauze dressings which quickly became saturated resulting in painfully denuded skin. The third patient was packed with an iodine strip and secondary absorbent dressing resulting in periwound maceration.

Current Clinical Approach: Patient one: stomahesive strips were used to build up the wound edges to accommodate the pouching system. One end of a wicking strip dressing was placed at the fistula and the other end placed inside the pouching system. Patient two: a thin hydrocolloid was applied to protect the skin while one end of wicking strip dressing was placed at the fistula and the other end placed inside a pouching system. Patient three: a thin hydrocolloid was applied to protect the skin surrounding the wound and a wicking strip dressing was used to pump the exudate from the wound into the pouching system.

Results and Conclusion: For patients one and two the wicking dressing was left in for 14 days before changing. The fistula decreased in size after 14 days for patient one. The strip dressing was then changed every two weeks until fistula closed after 60 days. For patient two the fistula was closed and periwound skin improved after 14 days. The dressing was changed weekly for patient three, and after 15 days the drainage was dramatically reduced. The use of the wicking strip dressing to transfer wound exudate to a pouching system is an effective method for managing exudate from fistulas and wounds.