Use of photograph to educate caregivers on care of complex fistula

A WOC nurse at an academic hospital in the Eastern United States  was approached by a transplant surgeon regarding care for a complex fistula on a young patient in a 3^rd world country with little resources. When provided with a photograph of this fistula, the WOC nurse was able to use a high resolution print out of the fistula to provide step by step instructions translated into spanish on how to manage fistula. The step by step guide along with donated supplies were sent to where patient was hospitalized and allowed for better containment of effluent and protection of  skin until surgery to repair fistula could be performed. The use of photographs and telemedicine can be used as a way to manage complex fistulas in areas with limited resources and minimal care giver knowledge.