Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each
HCPCS code
Name of the Procedure:
- Common names: Ostomy skin barrier with flange
- Medical term: Ostomy skin barrier (solid, flexible, or accordion) larger than 4 x 4 inches, without built-in convexity (HCPCS A4415)
Summary
An ostomy skin barrier with a flange is a medical device used to protect the skin around a stoma and secure a collection pouch. It is larger than 4 x 4 inches and does not include built-in convexity, which means it lies flat against the skin.
Purpose
- Medical conditions/problems it addresses: Used for patients with a stoma to manage waste securely.
- Goals/expected outcomes: To prevent skin irritation and ensure the ostomy pouch stays in place, reducing discomfort and infection risk.
Indications
- Specific symptoms/conditions: Patients with any type of ostomy (e.g., colostomy, ileostomy, urostomy).
- Patient criteria: Those requiring a larger skin barrier without convexity.
Preparation
- Pre-procedure instructions: Ensure the peristomal skin (around the stoma) is clean and dry before the application.
- Diagnostic tests: Generally, no specific pre-procedure tests required, but routine stoma care evaluation may be recommended.
Procedure Description
- Skin Preparation: Clean the peristomal area with mild soap and water, then dry thoroughly.
- Sizing the Stoma: Measure the stoma to ensure the correct size of the skin barrier opening.
- Cutting the Barrier: Using scissors, cut the barrier opening to match the stoma size.
- Applying the Barrier: Remove the protective backing from the barrier and gently press it around the stoma.
- Securing the Pouch: Attach the ostomy pouch to the flange on the skin barrier.
Tools/Equipment:
- Ostomy skin barrier with flange
- Stoma measuring guide
- Scissors
- Ostomy pouch
Anesthesia or sedation: Not required.
Duration
Applying the ostomy skin barrier usually takes about 10-15 minutes.
Setting
Typically performed in the patient's home or outpatient clinic. Nurses or caregivers may assist initially.
Personnel
- Healthcare professionals involved: Nurses, particularly ostomy care nurses, may assist the patient in learning the procedure.
Risks and Complications
- Common risks: Skin irritation, leakage, adhesive allergies.
- Rare risks: Severe skin breakdown, infection.
- Management: Proper hygiene, regular monitoring, and adjustments by healthcare providers.
Benefits
- Expected benefits: Enhanced skin protection, secure fitting, reduced leakage, improved comfort.
- Realization of benefits: Typically immediate, as the barrier provides an instant fit and protection.
Recovery
- Post-procedure care: Regular cleaning and monitoring of the peristomal skin.
- Recovery time: Not applicable; patients continue with regular ostomy care.
- Restrictions/Follow-up: Regular follow-up with healthcare providers to review stoma and skin health.
Alternatives
- Other options: Pre-cut skin barriers, barriers with built-in convexity, different sizes and types of barriers.
- Pros and cons: Customization with the described barrier vs. ease of use with pre-cut or convex barriers.
Patient Experience
- During the procedure: Minimal discomfort during application.
- After the procedure: Generally little to no pain; some initial adjustments may be required for comfort. Use of skin barrier powders and adhesive removers can further enhance comfort.