Isolation of Fistula and Ileostomy Drainage within Open Abdominal Wounds

Topic:  Device and method to accelerate the healing of enterocutaneous fistulae while increasing the longevity of NPWT wound dressings.

Purpose:  Heal abdominal wounds faster by using NPWT in the presence of an enterocutaneous fistula. 

Effectiveness of NPWT has been limited by wound dressing failure due to fistula effluent leakage. Effluent contamination causes tissue breakdown and infection with a loss of dressing seal as the system is overwhelmed with effluent, requiring frequent changes of expensive NPWT dressings. 

Objective:  A one-piece, compressible isolation device used with NPWT that directs effluent to a containment pouch.   This method allows for easy output measurements and preserves the integrity of the NPWT dressing.   Device and method are the result of an innovative work partnership between an abdominal reconstructive surgeon and a WOCN to deliver improved patient outcomes.

Outcomes:  This device and methods have been used in both trauma and non-trauma cases in the SICU of a Level I trauma center.  Specific cases on this poster are a gunshot wound to the abdomen with an enterocutaneous fistula and an ischemic bowel with an ileostomy in an open wound after a coronary artery bypass.  Each patient was unpouchable and dressings were being changed several times per hour.  Applying the device in combination with NPWT increased the dressing change interval to three days, accelerated wound healing, and facilitated accurate output measurements.