Name of the Procedure:

Ostomy Pouch with Extended Wear Barrier
HCPCS Code: A4388
Common Names: Colostomy Pouch, Ileostomy Pouch
Technical Terms: Ostomy Appliance, Drainable Ostomy Pouch with Integrated Barrier

Summary

An ostomy pouch with an extended wear barrier is a medical device designed for individuals who have undergone an ostomy surgery, such as a colostomy or ileostomy. This 1-piece system combines a drainable pouch and a barrier that protects the skin, collects waste from a stoma, and can be worn for prolonged periods.

Purpose

This device addresses the need for a convenient and hygienic way to manage waste for individuals who have had their colon or ileum diverted through the abdominal wall. The goal is to provide a secure, comfortable, and skin-friendly solution for waste collection.

Indications

• Patients who have undergone colostomy or ileostomy surgery.
• Individuals requiring an extended wear option due to active lifestyles or sensitive skin.
• Suitable for patients looking for a simple and efficient one-piece system.

Preparation

• Ensure the skin around the stoma is clean and dry.
• Read and understand the instructions provided with the pouch system.
• No specific fasting or medication adjustments are required.

Procedure Description

1. Preparation: Gather necessary supplies: the ostomy pouch with an extended wear barrier, scissors (if the barrier needs to be cut to size), and cleaning supplies.
2. Skin Prep: Clean the peristomal skin with water or a mild cleanser and ensure it is completely dry.
3. Sizing the Barrier: If necessary, cut the barrier opening to fit the stoma size.
4. Application: Remove the backing from the adhesive barrier and gently place the barrier around the stoma, ensuring it fits snugly.

5. Securing: Press down evenly to ensure a secure fit, eliminating any wrinkles or gaps.

   Tools and Equipment: Ostomy pouch (A4388), Scissors, Cleaning wipes

Anesthesia: Not applicable

Duration

Applying the ostomy pouch typically takes about 10-20 minutes.

Setting

This procedure is performed in a home or outpatient setting.

Personnel

Usually performed by the patient or a caregiver. In some cases, a stoma nurse or healthcare professional may assist.

Risks and Complications

• Skin irritation or damage around the stoma
• Leakage issues
• Allergic reactions to adhesive material

Benefits

• Provides a secure method for waste collection.
• Minimizes skin irritation with an extended wear barrier.
• Enhances quality of life by allowing active participation in daily activities.

Recovery

• Regular monitoring of the peristomal skin is essential.
• Change the pouch according to manufacturer guidelines or as needed.
• Follow-up with healthcare providers for any issues or complications.

Alternatives

• Two-piece ostomy systems
  • Pros: Can change the pouch without removing the skin barrier.
  • Cons: More components to manage.
• Disposable ostomy pouches
  • Pros: Easier for some users.
  • Cons: Increased cost over time.

Patient Experience

Most patients adapt to using an ostomy pouch with an extended wear barrier quickly. Initially, some discomfort may be experienced as the skin adjusts. Proper care and use of additional products like barrier rings can enhance comfort. Pain is not typical, and support from healthcare providers can ease the transition and troubleshooting.