Nursing of intestinal fistula in advanced colon cancer

The occurrence of intestinal fistula has a great relationship with our lives, so daily care is also very important during treatment. If our patients with intestinal fistula want to improve their quality of life after surgery, they must know what we need to pay attention to before and after the operation. Only in this way can we give patients the best care measures. In addition, after the operation, patients with intestinal fistula should receive psychological care based on their understanding of the disease, so that they can face their disease.

1. Preoperative care

In addition to routine care, the following aspects of care are also required

1) Bowel preparation: Fasting begins 35 days before surgery, vitamins that are not absorbed by the intestines are taken orally, and the fistula and the abandoned intestinal loops are irrigated (through the anus and fistula).

2) Skin preparation: Remove the tape, expose the local skin, clean the ointment and other dirt around the fistula, and keep it dry.

2. Postoperative Care

1. Closely observe the patient's condition: Complex enterocutaneous fistula surgery is very traumatic, with a lot of blood and fluid loss during the operation. Bleeding and fluid exudation may continue in the abdominal cavity after the operation. Therefore, you should closely observe changes in vital signs, bleeding and fluid exudation from the wound, and abdominal drainage, as well as the properties, color and amount of the drainage fluid, to be alert to the occurrence of hemorrhagic shock.

2. Nursing of various drainage tubes: After intestinal fistula surgery, various drainage tubes are often left in place, such as intestinal parallel arrangement tubes, intestinal fistula tubes, abdominal negative pressure drainage tubes, gastrointestinal decompression tubes, urinary catheters, etc. You should understand the functions of various tubes, strictly follow aseptic operation, be careful not to connect them incorrectly, properly fix them to prevent displacement and dislocation, and keep the tubes unobstructed; observe and record the color, properties and amount of each drainage fluid.

3. Nutritional support: Continue to use TPN, and perform enteral nutrition after intestinal function is restored. Because patients with intestinal fistula have a long course of disease and poor nutritional status, jejunostomy is usually placed during surgery and nutritional support is performed after surgery, or endoscopic percutaneous intervention is used to prevent jejunostomy tubes.

The above is the patient’s explanation of the nursing elements of intestinal fistula. However, our patients with intestinal fistula will have some complications as the disease continues to develop, especially infection. Therefore, when we perform some operations, we should strictly follow the principle of asepsis to provide care, give patients certain nutritional support, and let patients recover their health as soon as possible.