Certified Wound Ostomy Nurse (CWON) Practice Test

What is one method to facilitate spontaneous closure of a fistula?

1. Increase dietary intake significantly

2. Reduce fistula output

3. Enhance fistula drainage

4. Provide aggressive irrigation

The correct answer is: Reduce fistula output

Reducing fistula output is an effective method to facilitate spontaneous closure of a fistula. When the output from a fistula is minimized, it allows the surrounding tissues to heal and close naturally. High output from a fistula can lead to maceration of the surrounding skin, discomfort, and can also prolong the presence of the inflammation that prevents healing. Additionally, decreasing the volume of drainage can lead to a more favorable local environment for healing, reducing the risk of further complications such as skin breakdown or infection. In contrast, increasing dietary intake significantly may not directly address the underlying issue related to the fistula output and could potentially lead to increased intestinal content and drainage. Enhancing fistula drainage can keep the area clean but does not contribute to closure. Aggressive irrigation may worsen inflammation and disrupt any healing processes, as it can irritate the tissue and increase fluid output.