The suction pouch for management of simple or complex enterocutaneous fistulae

Containing effluent from an enterocutaneous fistula (ECF) requires expertise, critical thinking skills, and creativity. Using a combination of products readily available to WOC nurses practicing in the United States, I have designed a suction pouch that reliably contains fistula output. A standard ostomy pouch can be converted into a suction pouch by adding a large, single-lumen catheter into the pouch, sealing it, and connecting the assembly to low continuous suction. The resulting pouch can be used by itself to drain effluent from an ECF or it can be used in combination with wound dressings, or a negative pressure wound therapy system. Application of a suction pouch extends the integrity of the appliance and diverts succus away from the wound bed or the newly applied skin graft with increased reliability. This article describes the technique used to create a suction pouch, followed by 4 brief case descriptions that demonstrate feasibility of its use for the management of ECFs.