Clinical Evaluation of Fecal Incontinence Management System

Thursday, 15 July 2010

Chen Jen-Ru, RN
Nursing department, National Cheng Kung University Hospital, Tainan, Taiwan

Learning Objective 1: know how management for fecal incontience related buttock skin breakdown.

Learning Objective 2: know how to Safety and performance of an innovative system (FMS) for managing fecal incontinence .

Statement of Clinical Problem
33% of hospitalized patients had fecal incontinence during hospitalization. Managing diarrhea of patients without causing further damage can be clinical challenge.
Statement of Past Management
Traditional methods of managing faecal incontinence in patients who are
bedridden or immobilized include the use of pads, and anal tubes. But these are often difficult to achieve good adhesion to the perianal skin resulting in leakage and tube easy to dislocate.
     Initially, the patient was treated two or three times daily change of wound dressings was performed with the application of an SSD cream to the wounds, which were then covered with gauze.
Current Clinical Approach
This 66 y/o female had drowsy consciousness and persist yellowish watery diarrhea was noted. Thus, Her buttock skin breakdown and wound has VRE infection or colonization.
Because of the poor wound healing, large amount of wound exudate, and intractable pain. So, The dressings were changed Aquacel-Ag® every day and Flexi-Seal Fecal Management System (FMS) was used an inflated balloon to retain a tube within the rectum while an external pouch collects fecal material to maintain temporary continence in subjects with uncontrolled diarrhea.
Patient outcomes
The duration of treatment was 24 days.
  1. FMS reduce the frequency of bed linen changes, wound dressing changes
and/or nursing time spent cleaning patients.
   2. Decreased the spread of Buttock wound VRE infection.
   3. The patient feel comfortable in wound care.
This study case improving heal of skin breakdown and reduction of VRE wound infection rates during use of the FMS.
Fewer dressing changes were required, thus reducing unwanted patient discomfort and saving time for healthcare personnel. SHD is also cost-effective by decreasing the length of hospital stay and producing savings in clinical time.