Mdm Nur Madalinah Tan1, Ms Josephine Ong1
1Changi General Hospital, Singapore, , Singapore
ABSTRACT
Intestinal fistula is an abnormal connection between 2 epithelialized surfaces; it typically involves the gut and another hollow organ or skin.
Most commonly arises as complication of abdominal surgery; less commonly results from intra-abdominal inflammation or infection.
Case study is based on segment of bowel from fistula originates enterocutaneous. We faced several problems including: availability of supplies, control of exudate and quality of life issues for the patient.
Control of the effluent increased problems like skin breakdown, dehydration, malnutrition, and infection. Throughout the hospital stay, we tried several appliances, and none were successful for more than a week. The complications of the skin breakdown and frequent appliance leakage sights and smells caused a decrease in the patient’s self-esteem. With high output, the pouching systems are often not enough to contain the drainage and skin creases making it difficult to secure the pouches.
We tried various techniques and appliance to achieve a good seal, prevent skin breakdown and give patient a better quality of live. We had to use different types of fillers to level skin, create a pouch to contain effluent including gelling the content and creating an extension to a bigger containment system.
This non-healing ECF faces a lifetime of decreased quality of life, increased pain and expenses. The exudate is corrosive to the skin, causes odor and can be difficult to keep contained, unlike an ostomy. This is not a problem to take lightly as we are still finding a product that will last longer, cost effective and easy to manage.
Biography:
Degree with Honours from Edinburgh Napier University.
Graduate Certificate in Wound, Ostomy and Continence Practice with Curtin University and is registered with World Council Enterostomal Therapists.
She had her HMDP attachment in colorectal care in Chang Gung Memorial Hospital, Kaohsiung Taiwan in year 2012.
She has 36 years of working experience in both teaching and clinical care and is passionate in educating healthcare personnel and caregivers in colorectal and stoma wound care.
Interests in managing complicated wounds, stomas and faecal continence.
She has recently published in the WCET Journal
Secretary with Singapore Nurses Association Wound, Ostomy, Continence Nurses Chapter