Current fistula management.

April Mendoza, Erin Vanzant, Ashley Thompson, Dante Yeh

Journal: Current opinion in critical care 2024;30(2):172-177

PMID: 38441138

Abstract

PURPOSE OF REVIEW

Enterocutaneous fistulas (ECFs) pose a significant impact in the healthcare system, both financially and in resource utilization. Delivery of optimal care is complex and involves intensive wound care, complex nutritional delivery and multidisciplinary care teams for optimization. Recently, there have been pushes to modernize the traditional approach to ECF care to a new paradigm of protocol-based individualized delivery of care.

RECENT FINDINGS

There is an increased trend towards pushing enteral nutrition for the management of ECF patients. Adjuncts, including improved fistuloclysis devices, supplements and absorptive aides have challenged the conventional dogma of ECF treatment. There has also been increased focus on surgical prehabilitation and the ability to improve patient outcomes.

SUMMARY

ECF care is complex and requires a multidisciplinary approach focused on source control, nutritional optimization with focus on enteral nutrition, wound care and prehabilitation.

Address: University of Florida, Gainesville, Florida, USA.; University of California San Francisco-East Bay, Oakland, California.; Denver Health Medical Center, Denver, Colorado.

DOI: 10.1097/MCC.0000000000001147

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MeSH Terms: Humans, Enteral Nutrition, Parenteral Nutrition, Intestinal Fistula