Certified Wound Ostomy Nurse (CWON) Practice Test

What is a sign of an unhealthy fistula healing process?

1. Increased distal bowel output

2. Stable fistula output

3. Increased pain in the area

4. Decrease in purulent drainage

The correct answer is: Increased pain in the area

Increased pain in the area is a significant indicator of an unhealthy fistula healing process. Pain can signal infection, inflammation, or inadequate healing surrounding the fistula. Ideally, as a fistula heals, pain levels should diminish, not escalate. The presence of increased pain may also indicate complications such as abscess formation or tissue necrosis, which are concerning signs during the healing process. In contrast, stable fistula output and a decrease in purulent drainage are generally considered positive signs that indicate a more healed or healthy condition of the fistula. Furthermore, an increase in distal bowel output might be within expected limits depending on various factors such as the location of the fistula or its type, but it is not inherently a direct sign of unhealthy healing.