Wound, Ostomy and Continence Nurses Society (WOCN) Practice Exam

Why might surgical intervention for a fistula be postponed?

1. All perioperative factors must be managed

2. Fistulas are always self-healing

3. Patients must be on a clear liquid diet

4. Fistulas are associated with simple infections

The correct answer is: All perioperative factors must be managed

Surgical intervention for a fistula may be postponed because all perioperative factors must be managed to ensure safe and effective outcomes. This includes addressing the patient's nutritional status, fluid balance, and any underlying medical conditions or infections that may complicate the procedure. Proper management of these factors can significantly reduce the risk of complications and promote better healing post-surgery. In many instances, fistulas are associated with complex issues that require stabilization before any surgical approach can be considered. This might include the management of any associated abscesses, optimizing nutritional support, and controlling any systemic infections. Therefore, a thorough preoperative assessment and comprehensive management plan are critical steps that must take precedence to enhance surgical success and recovery. The other options do not accurately reflect the clinical reasons for delaying surgery. For instance, while some fistulas may resolve spontaneously, it is not accurate to say that all fistulas are always self-healing. Additionally, a clear liquid diet is not universally required for all patients with a fistula and is more specific to cases involving certain gastrointestinal conditions. Lastly, while fistulas can be linked to infections, they are often more complex than simply being associated with simple infections; many factors can contribute to their development and persistence.