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

A fistula that opens to a wound base is classified as what type?

1. complex fistula

2. simple fistula

3. high output fistula

4. low output fistula

The correct answer is: complex fistula

A fistula that opens to a wound base is classified as a complex fistula because it involves additional complications associated with its structure and the surrounding tissue. Complex fistulas are typically characterized by their involvement in more extensive injury or disease processes, such as radiation damage or malignancy, and they may also present with associated tissue loss, which is often seen with wounds. The presence of a wound base indicates that additional factors are at play, such as the need for healing of both the fistula and the wound itself. In contrast, simple fistulas are usually straightforward in their presentation and do not involve additional complications or extensive tissue damage. Output classifications, like high output or low output, refer more so to the volume of fluid that exits the fistula per day and do not account for the complexity of the anatomical and pathological context in which the fistula exists. Therefore, identifying a fistula that communicates with a wound base as complex fits into the broader understanding of wound care and the challenges associated with managing these types of fistulas in clinical practice.