Instructed patient classic barriers to spontaneous closure include distal obstruction, mucocutaneous continuity (ie, a short or epithelialized tract), and infection or malignancy in the tract. Comprehensive and effective management of the patient with fistula requires attention to fluid and electrolyte replacement, per fistula, skin, protection, infection control.
Instructed patient about external fistulas cause discharge through the skin. They are accompanied by other symptoms, including: abdominal pain, painful bowel obstruction, fever, elevated white blood cell count. Prevent skin maceration and breakdown from corrosive effluent and wound infection. Patient comfort, accurate measurement of effluents, patient mobility protect skin from damage from effluent, containment of effluent, odor control.
Instructed patient through the use of negative pressure wound therapy, a standard surgical drain, and optimized nutrition, fistula drainage was redirected and the abdominal wound healed, leaving a drain controlled enterocutaneous fistula. Patient control of fistula drainage and protection of surrounding tissue and skin is a principle of early fistula management.