Fistula and Ostomy Pouching

001 Pouch Flange Sandwich to Stop Leaks

Click here to see a demonstration of the pouch flange sandwich technique, which is used to form a superior seal around an ostomy pouch or wound manager to prevent leaks and Moisture Associated Skin Damage (MASD). This method can be used to secure a pouch or wound manager to the skin around a fistula or ostomy, or to a fistula isolation device. This technique is particularly helpful when a fistula bag keeps leaking and in cases of frequent ostomy pouch leaks.

002 Hybrid Dressing to Downsize Ostomy Pouches

Click here for the the hybrid pouch dressing technique, which can help reduce the size of the ostomy pouch or wound manager needed in cases where a fistula or ostomy is adjacent to a wound. This method can be used to form a stable pouch landing area and contain intestinal effluent while treating the wound area with advanced wound dressings.  This technique has the potential to reduce the size and associated cost of ostomy pouches and wound managers.

Fistula and Ostomy Isolation

003 Dressing Change Checklist

Click here to learn about the dressing change checklist, which is an important tool for successful and efficient dressing changes. Ensuring the patient is prepared for their change and having all the right dressing materials on hand is the recipe for success.

003 Dressing Change Checklist Download

Click here to download an example Dressing Change Checklist which may be a helpful reference when creating your own protocol.

004 Fistula and Ostomy Isolation with the Wound Crown

Click here to learn about the Wound Crown, which can be used to compress the surface of the body around an enteric fistula, stoma, or drain to seal and protect the skin from effluent.

020 Wound Crown High Output Fistula Case

Click here for a demonstration using the Wound Crown for a high output enteric fistula. The case features step-by-step dressing assembly while managing unpredictable effluent flows and important technique tips to prevent leaks and dressing failures.

005 Small Fistula Isolation with the Fistula Funnel

Click here to learn about the Fistula Funnel, which can be used to form a seal around smaller fistulas and ostomies, as well as medical tubes such as a fecal management system, urinary catheter or leaking PEG tube.

008 Multiple Fistula Isolation with the Isolator Strip

Click here to learn about the Isolator Strip, which is often used to create a curved or linear barrier. It can also be used to form a barrier ring around a group of fistulas.

026 RISP: Revise, Isolate, Skin Graft, Pouch

Click here for a demonstration of the RISP surgical technique to reconstruct peri-stomal and peri-fistula soft tissue for sidewall and hidden fistulas and retracted ostomies.

026 RISP: Surgical Reconstruction of Peri-fistula/stomal Soft Tissue

Click here to download the RISP poster presentation from SAWC Fall 2021. In some situations, the soft tissue around a fistula or ostomy makes it impossible to apply a pouch and contain effluent. The purpose of RISP (Revise, Isolate, Skin graft, Pouch) is to transition the patient to a standard, easy-to-apply ostomy appliance.

006 Sidewall Fistulas

Sidewall fistulas are challenging to manage but they can be isolated using the Wound Crown or Fistula Funnel. Click here to learn more.

Perineal Wound Management

014 Perineal Wound Leakproof VAC with Instillation

This session offers step-by-step instructions to help leakproof perineal VAC dressings for fluid instillation.

009 Perineal Wound and Burn Management

This technique can help providers manage burns and wounds to the perineum and may avoid surgical diversion with an ileostomy or colostomy.

Trouble-free NPWT

010 Leakproof VAC Ulta Pump Setup for Instillation

This introductory session includes dressing decision making, an overview of the VAC Ulta pump and basic step-by-step setup instructions to help leakproof vacuum dressings for Negative Pressure Wound Therapy (NPWT) with fluid instillation.

011 Advanced Leakproof VAC Ulta Pump Setup for Instillation

This follow up to the 010 Ulta Pump Setup introductory session offers step-by-step instructions for starting the pump in the VAC phase instead of the default instill phase.

019 NPWT Hacks: VAC Ulta Pump Blockage Alerts

Click here for straightforward fixes for blockage alerts that happen when using VAC dressings with fluid instillation.

028 NPWT Hacks: VAC Ulta Pump Leak Threshold

Click here for a demonstration of an easy way to increase the leak threshold setting on a VAC Ulta Negative Pressure Wound Therapy (NPWT) pump. Increasing the leak threshold can be helpful in mitigating error codes that happen with small VAC dressing leaks.

029 NPWT Hacks: VAC Ulta Pump 006 & 007 Error Codes

Click here for a demonstration of fixes for the 00000006 and 00000007 Error Codes on the VAC Ulta Negative Pressure Wound Therapy (NPWT) pump. Removing the accessories and restarting the pump typically resolves the error codes and the "yellow triangle of death" on the screen, allowing therapy to begin.

030 NPWT Hacks: VAC Ulta Pump Leak Detection Using Seal Check

Click here for a demonstration of how to use the seal check screen on a VAC Ulta Negative Pressure Wound Therapy (NPWT) pump to detect dressing air leaks. Monitoring the seal check indicator while checking the drape can help to more quickly identify dressing leaks.

Leakproof VAC with Instillation

012 Abdominal Wound Leakproof VAC with Instillation

Click here to learn about the use of Negative Pressure Wound Therapy with instillation for abdominal wounds.  Successful application requires knowledge of the structures under the wound and attention to detail in dressing preparation and placement.

013 Sacral Wound Leakproof VAC with Instillation

Click here to learn about the use of Negative Pressure Wound Therapy with instillation for sacral wounds. Placement of instillation ports and negative pressure bridging are key to success.

031 Skin-Sparing Technique for VAC with Instillation

Click here for a demonstration of the Skin-Sparing Technique for wounds with deep undermining when using Negative Pressure Wound Therapy (NPWT) / VAC with fluid instillation.

032 Gopher Tunnel Technique for VAC with Instillation

Click here for a demonstration of the Gopher Tunnel Technique for wounds with deep tunnels when using Negative Pressure Wound Therapy (NPWT) / VAC with fluid instillation.

023 Hip Disarticulation Leakproof VAC with Instillation

Click here for the "secret sauce" for leakproof VAC dressings with fluid instillation. Peri-wound skin prep and ostomy barrier rings are keys to eliminating leaks.

025 Pressure Injury Leakproof VAC with Instillation

Click here to learn about the use of Negative Pressure Wound Therapy with instillation for pressure injuries. Peri-wound skin preparation using the taco technique is critical to success.

016 Sacral Wounds with Blue Fused Dressing and Smart Instill

This session includes cases using the blue Cleanse Choice Complete dressing and a step-by-step sacral dressing demonstration using the Ulta pump with Smart Instill feature.

017 Taco Technique with Blue Fused Instillation Dressing

This session demonstrates the Taco Technique for deep wounds using the blue Cleanse Choice Complete dressing.

018 Extremity Wounds with Blue Fused Instillation Dressing

This session demonstrates techniques for extremity wounds using the blue Cleanse Choice Complete dressing.

Surgical Wound Management

015 Direct Peritoneal Resuscitation (DPR)

Direct Peritoneal Resuscitation (DPR) has been used for complex open abdomen patients and can help reduce time to abdominal closure, increase rates of facial closure, decrease ICU severity, and reduce risk of fistula formation.  Click here to view this session.

022 Orthopedic Trauma Leakproof VAC with Instillation

Click here to see the application of NPWT with instillation of hypochlorous acid acid solution to bolster the placement of synthetic Biodegradable Temporizing Matrix (BTM).

021 Below Knee Amputation Incision Management

Click here for a Prevena incision management device overview and example placements on a below the knee amputation incision.

027 Snap NPWT Wound Application

Click here for a demonstration of the Snap Negative Pressure Wound Therapy (NPWT) system on an open wound.

Canada Ukraine Surgical Aid Program (CUSAP)

CUSAP 10 Incision Management NPWT Dressings

Click here for incision management techniques using incisional Negative Pressure Wound Therapy (NPWT) dressings.

CUSAP 11 Scar Softening with Silicone Gel Sheets

Click here to learn how to soften a scar in preparation for reconstruction surgery with silicone gel application.

CUSAP 12 Surgical Drain Management

Click here to learn surgical drain placement, management and removal techniques.

CUSAP 14 Skin Graft Donor Site Foam Dressing Application

Click here for skin graft donor site management techniques using a non-adherent antimicrobial foam dressing.

Canadian medical team helps Ukraine war victims (2022)

A Canadian medical team and one American wound nurse recently returned from a mission to Poland, where the group of volunteers helped injured Ukrainian soldiers and civilians.  See the story.

Education

Managing Difficult Stomas and Fistulas: Keys to Success (2023)

Click here to view this session on managing difficult stomas and fistulas from the Colorectal Surgery Virtual Educational Series (CRS).

Decision Framework for Enteric Fistula Management (2022)

Click here to download the enteric fistula decision making framework poster presentation from WOCNext 2022. This framework can help providers determine the appropriate therapy when faced with a challenging enteric fistula.

Enteric Fistula: Is Management in South Africa and the U.S. the Same? (2022)

Click here to log in and view this session from WOCNext 2022, which provides holistic, global approaches comprehending skin and sepsis, nutrition, patient anatomy, and surgical procedures for the fistula patient population.

Principles of Enteric Fistula Management (2021)

Click here to view this session from the 2021 Stepping Stones to Excellence in Wound Care Conference, which covers assessment and classification of the enteric fistula patient, medical management, wound care best practices and surgical revision and skin grafting. 1.0 CE credit available.

The management and prevention of infection focused on surgical wounds (2022)

Click here to view this session from Wounds Week 4, which discusses the identification and management of postoperative incisional infections, enteric fistulas, wound dehiscence, and the options for management of these serious patient conditions.

Leveraging Innovation to Optimize Success with Negative Pressure Wound Therapy with Instillation (2022)

Click here to take this free one credit course which is designed for surgeons and wound care professionals who manage wounds in the acute care setting. 1.0 CE credit available.

Challenges of Necrotizing Soft Tissue Infections (2022)

Click here to download the Necrotizing Soft Tissue Infection (NSTI) clinical decision making poster presentation from SAWC Spring 2022. NSTI is characterized clinically by fulminant tissue destruction, systemic signs of toxicity, and high mortality. Rapid diagnosis, patient transfer to a tertiary center and wide debridement improve chances of survival.

Challenges of Complex Wound Care (2021)

Click here to view this session from the 2021 Stepping Stones to Excellence in Wound Care Conference, which covers the challenges associated with healing complex wounds. 1.0 CE credit available.

Skin Graft Site Preparation for Soft Tissue Injury (2021)

Click here to download the necrotizing soft tissue injury poster presentation from SAWC Fall 2021. This presentation shares outcomes for patients who received a synthetic biodegradable temporizing matrix to temporarily close the wound and aid the body in generating new tissue in preparation for a skin graft after devastating loss of skin.

Fistula Solution Knowledge Center

Click here for a comprehensive archive of fistula management literature, tools and techniques.

Interviews

Minnesota trauma nurse joins team who saved his life (2021)

See the story of a fistula survivor who is following in the footsteps of his complex wound and fistula nurse.

The Frank & Lizzie Show (2021)

See the pilot episode of The Frank & Lizzie Show with special guest Mary Anne Obst, RN, CWON, CCRN. This morning talk-show style channel features clinicians and products within the wound care community. Mary Anne highlights her work as an innovator with Fistula Solution®.