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Eakin products for skin protection around a fistula

This case study looks at the use of Eakin products to manage skin protection around a fistula.

By Des Davies, acting Clinical Nurse Consultant from SCGH Perth WA

Patient history

  • 68  year old male
  • Lives with wife in own home
  • Lives in rural western Australia
  • Complex medical and surgical history
  • 2015 subtotal colectomy, Splenectomy, partial gastrectomy secondary to low grade Adenocarcinoma at splenic flexure - formation of Ileostomy
  • Reversal of loop-Ileostomy 12-02-15
  • Post-Operative - anastomotic leak – Re-do Laparotomy & washout& redo ileo-rectal anastomosis.
  • Wound Breakdown- washout and new enterocutanous fistula with abdominal collection 13-02-15
  • Patient discharged against medical advice on 16-2-15
  • Patient re-admitted on 20-2-15
  • Patient transferred to SCGH
  • INVESTIGATIONS
  • Chest x-ray
  • C.T.Abdomen
  • Blood profile
  • Swabs from wounds & fistula site
  • MSU
  • Diagnosed with rectal tumour

Patient Management: of medical conditions

  • ICU/HDU Admission
  • NSTEMI
  • GI Bleed
  • Acute Cholecystitis
  • SVT/AF likely to sepsis
  • UTI
  • TPN for 6 months

Case details 

Wound swab taken, 3m Barrier wipe, Eakin cohesive slim seal to top & right fistula and Eakin seal rolled into sausage shape applied to the edge of large fistula. 

 

Top fistula has healed, however below large fistula another smaller fistula had developed. Eakin wraps used around large fistula as the edges where starting to roll inwards, Eakin Pouch applied. Bottom fistula Eakin slim seal oval Eakin pouch.

Months later: Healed peri–fistula skin, using Eakin wraps to large fistula and Eakin slim seal to other two fistulas with pouch- able to leave pouches in situ for 7 days.

Skin in excellent condition – Doctors , Stomal Nurse and Patient very happy. 

Large fistula with Eakin pouch. Bottom fistula with Eakin Seal and wound management bag . Right fistula Healed.

Large fistula, Eakin wrap used due to fistula in deep dip & pouch. Bottom fistula Eakin slim seal and Eakin pouch, Right fistula healed. However patient had a collection –Pigtail drain inserted. 

Pigtail drain above healed right fistula. Leakage from pigtail drain site. Eakin paste and Eakin slim seal used to protect the skin. Pouch applied pigtail placed into pouch, a cut was made in pouch bring the pigtail drain to outside, pouch sealed with opsite to prevent leakage. attached pigtail to sat lock. Foam dressing under 3 way tap to prevent pressure injury.

Fistula output reduced able to use Eakin slim seals to both fistulas and Eakin Pelican pouch.