The basic objectives of skin care management of GI fistulas are the prevention and management of skin breakdown and the promotion of healing of an open wound with a draining fistula by the containment of effluent. Skin or wound care management is one component of the overall medical-surgical management of patients with GI fistulas. This component plays a significant role in promoting patient comfort and well-being and mechanical control of unwanted drainage on the skin. When these objectives are achieved through the use of various products and methods discussed, nutritional and medical management can proceed until an optimal time when surgical repair or spontaneous closure is possible. If surgical repair or spontaneous closure is not an expectation, as in a patient with enterocutaneous fistula secondary to an abdominal tumor and metastatic disease, skin care management without resolution of the problem may continue for some time. In this case skin care management and patient comfort may be the primary focus. Short-term or long-term wound care management must incorporate not only desirable patient care outcomes but also cost and availability issues. Effective use of the caregivers' time, whether it is nursing or other family members, must be taken into consideration. ineffectual skin care rituals that consume excessive time and expense without good patient outcomes must be eliminated. Availability of knowledge regarding basic skin or wound care principles and products, creativity, and availability of products for management are other significant factors that impact on successful skin care management. Effective skin and wound care management is derived from a systematic approach that incorporates an accurate assessment of the fistula and surrounding skin or wound. An accurate assessment of the individual's needs and expected outcomes is also a part of the systematic approach. The simplicity or complexity of an effective wound care management plan must be communicated so that others may duplicate the procedures and thus maintain continuity of care and achievement of patient care objectives.