Abstract
The purpose of this clinical report is to assess the cost performance of the pouch drainage method in comparison with the gauge dressings method,involving frequent changes of dressings,in jejuno-cutaneous fistula management. We treated a jejuno-cutaneous fistula with severe skin erosion around the fistula with FOY（gavexate mesilate）ointment and gauze dressings；however,there was no improvement. Therefore,the better to manage the skin lesion,pouch drainage was tried with Surgidrain Open-Top A-M（Alcare Co.,Ltd.）together with some other devices,and after ten days the erosion improved.
We calculated the total equipment cost and the daily cost of the fistula management for both the gauze dressing and the pouch drainage methods,and also the frequency of equipment exchange for both methods of fistula management.
1. The total cost of the dressings for the fistula management
Gauze dressings ¥58,963
Pouch drainage ¥26,050
2. The frequency of changes of dressings for the fistula management
Gauze dressings 3.1 times/day
Pouch drainage（before skin irritation improvement）
0.7 -1.8 times/day
（after skin irritation improvement）
0.2 times/day
3. The daily costs of the fistula management
Gauze dressings ¥2,746/day
Pouch drainage（before skin irritation improvement）
¥1,280-¥1,686/day
（after skin irritation improvement）
¥484/day
In conclusion it is clear that the advantages of pouch drainage in fistula management include：（1）an improvement in skin irritation,（2）no need for frequent dressings exchanges,（3）lower cost in comparison with gauze dresssings.
