Intestinal fistulae formation in the open abdomen is a rare, but devastating and complex complication for patients. Often, there will be no spontaneous healing or closure of the fistulae. Effective wound care is essential to contain fistulae effluent, protect surrounding tissue and skin, and promote granulation, and patient comfort and mobility. Management options include the use of wound management pouches and negative pressure wound therapy. Effective wound care needs to be underpinned by adequate nutrition, and fluid and electrolyte management. Despite the challenges involved in providing effective care for these patients, this aspect of nursing practice can be extremely rewarding.