Achieving closure of the high output enterocutaneous fistula with the use of an extracellular matrix in patients with multiple comorbidities

Achieving closure of the high output enterocutaneous fistula with the use of an extracellular matrix in patients with multiple comorbidities

6^th International Conference on Wound Care, Nursing and Tissue Science
May 20, 2022 | Webinar

Ann Marie Lanza-Bisciello

Frontier Nursing University, United States

Scientific Tracks Abstracts : J Trauma Crit Care

Abstract:

Topic: An enterocutaneous fistulas is an abnormal passage that develops between the intestine and the skin. Enterocutaneous fistulas can develop spontaneously but most are iatrogenic and develop postoperatively. They develop more commonly in patients with multiple comorbidities. High output enterocutaneous fistulas are challenging to manage, maintain output and get to closure. The spontaneous closure rate for this type of complex fistula is less than 10%. Patients that develop an enterocutaneous fistula have a higher mortality rate due to sepsis, nutritional abnormalities, and electrolyte imbalance. Purpose: The use of an extracellular matrix to achieve closure of the high output enterocutaneous fistula in patients with multiple comorbidities that failed to close using traditional medical management. Process: The extracellular matrix was applied weekly until closure. The wound bed surrounding the fistula was debrided of any non-viable tissue. The extracellular matrix was applied in two forms powder and a two-layer sheet. A negative pressure wound therapy system was placed on low continuous suction for the first two applications and then a pouching system was used to maintain output. The extracellular matrix facilitates the body’s ability to remodel site appropriate tissue to achieve healing. Outcomes: Closure of the high output enterocutaneous fistula occurred after five weekly applications of extracellular matrix. References 1. Sasse KC, Ackerman EM, Brandt JR. Complex wounds treated with MatriStem xenograft material: case series and cost analysis. OA Surgery 2013 Dec 01;1 (1): 3 2. Bryant, R. A. Acute and chronic wounds: Current management concepts. Ann Med Surg (5th ed.). Elsevier Mosby, 2016 3. Hiles, M., Nihsen, E., & Hodde, J. Biologics in Fistula Surgery: Parallels with Chronic Wounds. Seminars in Colon and Rectal Surgery, 2009, 20(1): 32–37

Biography:

Ann Marie Lanza Bisciello has 14 years of nursing experience across the health care continuum and is board certified as a wound ostomy and continence registered nurse and an adult geriatric primary care Nurse Practitioner. She is currently the Wound Care Manager at New York Presbyterian Hospital Lower Manhattan Campus. She is the chair of skin care council; she designed and implemented educational programs for wound, ostomy care. Ann Marie has been an active member of the Metro New York Affiliate of the WOCN Society for the past eight years. She has served as President and is now the President elect for the Affiliate.

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