Certified Wound Ostomy Nurse (CWON) Practice Test

Which of the following indicates progress in healing a fistula?

1. Increased fistula output

2. Decreased distal bowel output

3. Decreased fistula output

4. Increased abdominal pain

The correct answer is: Decreased fistula output

Decreased fistula output is a key indicator of progress in healing a fistula. When the output from a fistula diminishes, it often signifies that the surrounding tissue is undergoing healing, and there may be a reduction in the secretions produced by the affected bowel segment. As the pathological process resolves and the fistula begins to close, one would expect to see less fluid collecting in and draining from the fistula site. This decreased output is a positive sign in the management of fistulas, as it shows a shift towards recovery and closure of the defect. In contrast, increased fistula output typically suggests ongoing inflammation or a failure to heal, which may require further intervention. Decreased distal bowel output could indicate other bowel management issues or complications rather than directly reflecting the healing progress of the fistula itself. Lastly, increased abdominal pain is often a negative sign, possibly indicating complications such as inflammation or infection, rather than an indicator of healing. Thus, monitoring the output of the fistula is a critical part of assessing the healing process, with decreased output being the ideal outcome.