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J Wound Ostomy Continence Nurs ; 44(3): 293-298, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28472817

RESUMEN

BACKGROUND: A 54-year-old morbidly obese woman with a small bowel obstruction and large ventral hernia was admitted to hospital. She underwent an exploratory laparotomy, lysis of adhesions, and ventral hernia repair with mesh placement. She subsequently developed an enteroatmospheric fistula; several months of hospital care was required to effectively manage the wound and contain effluent from the fistula. METHODS: Several approaches were used to manage output from the fistula during her hospital course. She was initially discharged to a skilled nursing facility where a fistula management pouch was used for several months to encompass the wound and contain effluent, but this method ultimately proved ineffective. The fistula was then isolated using a collapsible enteroatmospheric fistula isolation device and an ostomy appliance to contain effluent. CONCLUSION: The application of the collapsible enteroatmospheric fistula isolation and effluent containment devices in conjunction with negative-pressure wound therapy produced positive patient outcomes; it improved patient satisfaction with fistula management, promoted wound healing, and diminished cost.


Asunto(s)
Fístula Intestinal/terapia , Terapia de Presión Negativa para Heridas/métodos , Complicaciones Posoperatorias/enfermería , Cicatrización de Heridas , Técnicas de Cierre de Herida Abdominal/enfermería , Técnicas de Cierre de Herida Abdominal/normas , Femenino , Cuidados de Enfermería en el Hogar/métodos , Cuidados de Enfermería en el Hogar/normas , Humanos , Laparotomía/efectos adversos , Persona de Mediana Edad , Terapia de Presión Negativa para Heridas/normas , Obesidad Mórbida/complicaciones , Obesidad Mórbida/enfermería , Estomía/instrumentación , Nutrición Parenteral Total/enfermería
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