|
|
|
|
|
|
|
|
E-Mail This Newsletter |
|
|
|
|
Printer-Friendly Version |
|
|
|
|
Subscribe to our Newsletter |
|
|
|
|||
|
||||||||||||||||||||
Volume 31, Number 9 June, 2004
WHICH POUCHING SYSTEM IS RIGHT FOR YOU?
By Gwen Turnbull, BS (a pioneer ostomy nurse Via: Northern Virginia Pouch
With so many ostomy products available, it’s hard to know which one is right for you. Regardless of the brand of product or type of surgery you have, there are a few basic features an ostomy pouching system must have to give you a sense of security and confidence.
First, it must contain urine or stool, gas and odor without leaking.
Second, it must help protect the skin around the stoma from damaging effects of stool or urine.
Third, the systems should remain in place for a sustained and predictable wear time.
Wear time—This means you should be fairly certain your pouching system will remain intact without leakage for a definite period of time. That time period varies among individuals and ranges from 24 hours to 7-10 days.
Wear time- has a lot to do with the amount and character of your output, the climate in which you live, your daily activities, and the type of skin barrier you use.
Output — High volume liquid output will melt standard, pectin-based barriers faster than the more modern synthetic extended-wear barriers. Using a skin barrier paste as “caulking” around the stoma or a “bead” on the back of the skin barrier, can help increase wear time and skin protection.
Visibility/Intimacy/Cost — Once the above criteria have been met, look at other pouching system features that might impact the way you feel about yourself. For example, is the pouch visible under your clothing, and does that determine your feelings about yourself during periods of intimacy? Do ostomy supply costs, or worry about them, overwhelm you?
Your Adjustment — Researchers believe that such concern can affect your adjustment to, and satisfaction with, your life after ostomy surgery. That’s why it’s important to look at the fine distinctions about ostomy pouching systems. Consider a system’s wear time as it relates to its costs. Calculate your ostomy supply costs on a yearly total-cost basis rather than a cost per change basis. You may find that an inexpensive pouch that must be changed daily costs more in the long run than the more expensive pouch you can wear for three days.
Conclusion — Investigate the size, shape, color, contour, profile and ease of application and emptying of a variety of pouching systems. Which one will be right for you? The one YOU FEEL is right for you!
Editor’s Note: All ostomy manufacturer’s will be glad to send you free samples if you will contact them. Most manufacturers advertise in the OQ magazine and also your ostomy nurse can make suggestions.
NO NEED TO SING, THE POUCH POPPIN’ BLUES
Adapted by The New Outlook, Chicago’s North Suburban Chapter, Via: Charlotte NC Chapter, Pittsburg PA & Fairfield OH Chapters
Worried about your pouch popping off? Good! You’re not dead, yet!
Take heart. These days with the advances in modern appliances, and if care has been taken when the pouch was applied, this will almost never happen. But we need to do our part. Look, pouches pop off when they’re full, and we move fast. So, if you don’t want to stop moving, better keep that pouch pretty empty. For this reason, some ostomates wear the big pouches. Many of our members wear 9 inch pouches because they show less and are more convenient. Some of the smaller pouches actually look sporty. I personally like a sporty looking pouch.
There is no real issue with having a full pouch, if you empty when you urinate. A male member said, “The biggest change my ostomy has made in my life is that I never use the urinal any more.” He empties his pouch every chance he gets, which means that he empties it when he urinates. Most of us don’t make special trips to the bathroom just to empty a pouch, unless one has a urostomy. This statement applies mostly to ileostomates.
ILEOSTOMY RETRACTION
by Gail Wilhite, RN, ET, from Metro Maryland, Via: Ocala FL & S. Brevard FL Ostomy Newsletter
An ileostomy stoma should be at least 3/4” in length and some surgeons advocate a longer length of 1” to 1 1/2 “. A spout-like stoma is necessary to deposit the effluent into the bag preventing pooling of contents at the base of the stoma. Conversely, a stoma that is too long is subject to external trauma and injury. Weighing the consequences, it is preferred to have a stoma somewhat too long than one too short. There is a difference between the creation of colostomy and ileostomy stomas. Frequently, when fashioning a left-sided colostomy, the surgeon will create a flush stoma. The contents of the left colon are relatively inert and usually regulated with irrigation, therefore, little or no functional problems occur with a flush colostomy stoma. An ileostomy stoma is never constructed as a flush stoma; nevertheless, sometimes the stoma may retract for various reasons.
The common cause of stomal retraction is post-op weight gain. Prior to their operations, most ileostomates have lost considerable weight. Following surgery, weight gain can be rapid, and, many times, excessive. What once was an adequate stoma, now retreats within the expanding environment! Another cause of retraction may be inadequate fixation of the opposing serosal layers following eversion. If these layers fail to adhere, healing and subsequent scarring may tend to draw the stoma into the abdomen.
Problems resulting from retraction are decreasing adherence of the appliance and skin breakdown. The pooling of the excoriating intestinal contents cause the loosening of the adherent bond resulting in leakage of ileal effluent on the skin. This skin –effluent contact naturally produces breakdown. The combination of irritated, weeping peristomal skin and continual pooling leads to an unbearable situation, which must be remedied.
The treatment for a slightly retracted stoma is the use of a convex faceplate. The convexity applies pressure on the skin surrounding the stoma, thus pushing the stoma up. When using a convex faceplate, it is important not to lose the convexity by applying thick washers or foam pads, etc. The skin and faceplate should suffice to maintain the advantages of both convexity and skin protection. If the use of a convex faceplate proves unsuccessful or if the retraction is severe, then surgery is advised to create a new, longer stoma.
THOUGHTS ON ODOR MANAGEMENT
by Rosemary Van Ingen, ET, Via: Northern Virginia Chapter Pouch
Isn’t it interesting that people with normal intact bowel tracts and urinary systems manage odor problems in an acceptable manner in our society? But when disease or trauma strikes, and the person is the owner of an ostomy, the one big concern is the fear of offending society with an odor.
What’s an ostomy?
Basically an ostomy is a man-made exit site that changes the point of exit from the bottom or back of our body to the front. Our eyes and noses are obviously on the front of our body, which leads us to be more aware of our changed body image and our odor-producing products.
I’m sure you’ve heard the statement, “You’ve come a long way, baby.” Yes, ostomy management has come a long way-considering that as little as ten years ago, we had very few 100% odor-free pouching systems.
Ostomy Collecting Receptacles
When ostomy surgery was first developed, ostomates wore anything to collect output. Tin cans, rubber gloves, cups of all shapes and sizes, bread wrappers,
and plastic margarine cups just to mention a few, were standard equipment for the ostomate. Not only the feasibility, but the odor problems this type of equipment produced, was enough to give ostomy surgery and people who had ostomies a very deplorable place in our society. Presently, almost all the ostomy pouching systems available to us today are made of odor-barrier materials.
Odor Detective Work
Therefore, if an ostomate does have a fecal or urinary odor about them, some detective work should be done:
Check out the application of the pouching system to the body. Is it leaking?
Check out the closure of the pouching system—is it closed properly so that no fecal matter is oozing out after the closure?
Do not put holes in the pouch as gas will seep out continuously.
Urostomy Odor Cautions
The urostomate should rinse or wipe off the spout of the pouching system with a bathroom tissue after emptying. Those few drops left in the spout after closing the pouching system can cause a urine odor under clothing It is interesting to note that most urostomy pouching systems on the market are odor-proof, but the connecting tubing and bedside and leg bag are not. You must dispose of and replace these products when they take on urinary odors, or else your entire living quarters will smell.
Elimination in Ostomates vs Non-Ostomates
Emptying an ostomy pouching system is comparable to a person with an intact bowel or urinary tract having a bowel movement or emptying their bladder. How does the non-ostomate handle the odor produced by the normal function of their body? Room deodorizing sprays are popular; a quick flush of the toilet when defecation occurs, and opening a window are some acceptable methods that have been used for odor management.
Why are Ostomates so uptight about elimination odors when our pouching systems are emptied?
This constant complaint has encouraged ostomy supply manufacturers to create products to meet the need for odor control. Just remember, there is not a man or woman on this earth whose wastes do not smell. If someone tells you that their waste products are odorless, then a nose overhaul is in order for them!
Sign up for Evansville Ostomy Monthly Newsletter
