Name of the Procedure:

Ostomy Skin Barrier with Convexity

Summary

An ostomy skin barrier with convexity is a medical device used to protect the skin around a stoma—a surgically created opening on the abdomen for waste elimination. The barrier helps secure an ostomy pouch to the skin, preventing leakage and skin irritation.

Purpose

The ostomy skin barrier is designed to prevent skin irritation and leakage for patients with a stoma. The built-in convexity helps create a better seal around the stoma, especially for those with recessed or flat stomas.

Indications

• Presence of a stoma (e.g., colostomy, ileostomy, or urostomy).
• Need for a secure seal to prevent leakage.
• Patients with flat or recessed stomas which make standard barriers ineffective.

Preparation

• Clean the peristomal skin thoroughly.
• Measure the stoma to ensure the correct size of the skin barrier.
• No specific fasting or medication adjustments are needed unless otherwise directed by a healthcare provider.

Procedure Description

1. Clean the area: Gently clean the skin around the stoma with water and mild soap. Dry thoroughly.
2. Measure and cut: Measure the stoma size using a stoma measuring guide and cut the barrier opening to fit.
3. Apply the barrier: Peel off the backing of the skin barrier and apply it gently but firmly around the stoma.
4. Attach the pouch: Secure the ostomy pouch to the barrier by pressing it around the flange area.

Tools: Stoma measuring guide, ostomy scissors, ostomy skin barrier, and ostomy pouch. Anesthesia: None required.

Duration

The application of the skin barrier typically takes about 10 to 20 minutes.

Setting

The procedure is generally performed at home by the patient or a caregiver. Initial training and demonstration could take place in an outpatient clinic or hospital.

Personnel

• Primary: Patient or caregiver
• Support (initial training): Nurse, preferably an Enterostomal Therapy (ET) nurse or Wound, Ostomy, and Continence (WOC) nurse.

Risks and Complications

• Skin irritation or damage if improperly applied.
• Allergic reaction to the barrier material.
• Potential leakage if not well-fitted or properly secured.

Benefits

• Improved skin protection around the stoma.
• Reduced risk of leakage.
• Enhanced comfort and security.

Recovery

• No recovery time needed.
• Regular monitoring of the stoma and surrounding skin.
• Change the barrier every 3-7 days, or as needed.
• Follow-up with healthcare provider if issues arise.

Alternatives

• Standard flat skin barriers without convexity.
• Custom-fitted barriers.
• Barrier rings or pastes for additional security.

Pros: Convex barriers are more effective for recessed stomas. Cons: May be more expensive and take practice to apply correctly.

Patient Experience

• Patients may feel a sense of security with a reduced risk of leakage.
• Initial application might cause mild discomfort but generally not painful.
• Daily activities can usually be resumed immediately after application.
• As the patient gains experience, the process will become quicker and more routine.