Certified Wound Ostomy Nurse (CWON) Practice Test

Why might surgical intervention be delayed with the presence of a fistula?

1. Correcting all contributing factors is essential

2. Fistulas are typically self-healing

3. Frequently, patients are not ready for surgery

4. Only minor adhesions need to be dealt with

The correct answer is: Correcting all contributing factors is essential

The presence of a fistula often indicates underlying issues that need to be addressed before considering surgical intervention. The rationale for delaying surgery is rooted in the need to correct all contributing factors that may be leading to the fistula formation. This may include managing inflammation, resolving any obstructive pathology, and ensuring that nutrient deficiencies or other systemic issues are treated. Addressing these factors can significantly improve the chances of successful healing and reduce the risk of post-operative complications. While some fistulas may have self-healing capabilities, this is not universally applicable, and many factors influence a fistula's healing potential. Additionally, while patients may sometimes not feel ready for surgery, this is not a primary reason for delaying intervention, as readiness can be assessed and optimized. Lastly, while adhesions can be present, stating only minor adhesions need to be dealt with oversimplifies the complexity of fistula management and does not reflect the need for comprehensive care. Therefore, correcting contributing factors before proceeding with surgery is crucial for a favorable outcome.