Name of the Procedure:

Ostomy Skin Barrier, with Flange; also known as Ostomy Skin Barrier, Extended Wear, with Built-in Convexity.

Summary

This procedure involves the use of an ostomy skin barrier with a built-in convexity designed to protect the skin around a stoma, enhance comfort, and ensure a secure fit. The barrier measures larger than 4 x 4 inches and is typically used with an ostomy pouching system.

Purpose

The ostomy skin barrier aims to protect the skin from the output of the stoma, prevent irritation, and provide a secure and comfortable attachment for the ostomy pouch. It is particularly useful for patients with sensitive skin prone to irritation, or those requiring extended wear time due to activity levels or preferences.

Indications

• Stoma with an irregular shape or prone to leakage.
• Peristomal skin irritation or damage.
• Patients requiring a secure and comfortable barrier for extensive periods.
• Enhanced fit for stomas flush with the skin or retracted.

Preparation

• Cleanse the stoma and the surrounding skin thoroughly.
• Ensure the skin is dry before applying the barrier.
• Measure the stoma to ensure correct sizing of the skin barrier.
• Trim the barrier as necessary for a perfect fit around the stoma.

Procedure Description

1. Clean the peristomal area with lukewarm water and mild soap, then pat dry.
2. Measure and cut the barrier to fit securely around the stoma.
3. Remove the paper backing from the barrier.
4. Center the barrier over the stoma and gently press it into place, ensuring a snug fit.
5. Attach the ostomy pouch to the flange of the barrier.
6. Smooth out any wrinkles to ensure a secure fit and prevent leakage.

Tools, equipment, or technology used:

• Ostomy skin barrier with built-in convexity and flange.
• Ostomy pouching system.
• Scissors (for trimming the barrier).
• Mild soap and water for cleaning.

Anesthesia or sedation details:

• None required.

Duration

The application of the ostomy skin barrier typically takes about 10-15 minutes.

Setting

This procedure is usually performed at home by the patient or a caregiver, but initial guidance and instruction can be provided in a hospital or outpatient clinic.

Personnel

• Initial training may involve a stoma care nurse or healthcare professional.
• Routine application is typically done by the patient or a caregiver.

Risks and Complications

• Skin irritation or allergic reaction to the barrier materials.
• Leakage if not applied properly.
• Infection if the skin barrier is not changed regularly or cleaned adequately.

Benefits

• Protects peristomal skin from irritation and damage.
• Provides a secure fit for extended wear, enhancing comfort and confidence.
• Reduces the risk of leakage, allowing for better management of stoma output.

Recovery

• Generally, no recovery time is needed.
• Follow-up with a stoma care nurse or healthcare provider may be necessary to address any issues.
• Immediate return to normal activities expected.

Alternatives

• Flat ostomy barriers without convexity.
• Custom-molded barriers.
• Barrier rings or strips in conjunction with a flat barrier.
• Different pouching systems depending on individual needs.

Pros and cons of alternatives:

• Flat barriers might be less effective for stomas prone to leakage and skin irritation.
• Custom-molded barriers may offer a better fit but can be more expensive.
• Barrier rings add additional steps and products to manage.

Patient Experience

• Patients might experience some initial discomfort as they adjust to the new barrier.
• Over time, it generally becomes more comfortable and a routine part of care.
• Proper fitting and application enhance comfort and confidence in daily activities.
• Pain management is typically not necessary; however, managing skin health is crucial for comfort.