Скачать или смотреть WCE 21 Tube, Drain, and Fistula Management

#WoundCare #TubesAndDrains #EnterocutaneousFistula #ECF #OstomyCare #NutritionalSupport #InfectionPrevention #SkinCare

This video, based on "Wound Care Essentials", provides a deep dive into managing percutaneous tubes, drains, and enterocutaneous fistulas (ECFs). These are increasingly common in healthcare and pose significant challenges, including maintaining fluid balance, protecting skin, preventing infection, and ensuring good nutrition.

Percutaneous tubes and drains create deliberate pathways through the skin to internal organs or spaces for various purposes like drainage, decompression, lavage, medication delivery, and nutritional support. Understanding the device's specific location, function, and manufacturer guidelines is crucial for proper management. Key principles for managing tubes and drains include ensuring stability to prevent accidental removal, meticulous skin care around the insertion site, and implementing infection prevention strategies. Common types discussed include tracheostomy, esophogostomy, biliary, nephrostomy, indwelling urinary catheters, and enteral feeding tubes (NG, G, J, PEG). Patient and family education is highlighted as vital for reducing anxiety and improving compliance.

Enterocutaneous fistulas (ECFs) are serious abnormal connections between the gut and the skin, resulting in uncontrolled leakage of intestinal contents. They are relatively uncommon but carry high risks of mortality due to infection, fluid/electrolyte imbalances, and malnutrition. ECFs are classified by anatomy, complexity, and especially output volume, with high output fistulas (500ml/24h) being particularly challenging to manage. Management goals involve correcting fluid and electrolyte deficits, providing aggressive nutritional support (often TPN initially), preventing and managing infection, and accurately mapping the fistula tract. Protecting the surrounding skin from corrosive drainage using specialised containment systems (pouching) is paramount. Negative pressure wound therapy (NPWT) may be considered in specific, carefully managed situations. Effective management necessitates a collaborative, interdisciplinary team approach and comprehensive case management, especially for long-term care. Success depends on early identification, robust medical support, diligent skin protection, and vigilant monitoring.