Name of the Procedure:

Common Name: Drainable Ostomy Pouch with Barrier and Filter
Technical/Medical Term: HCPCS Procedure A4424

Summary

A drainable ostomy pouch with a barrier and filter is a one-piece system used by individuals with a stoma. The attached barrier adheres to the skin around the stoma to securely hold the pouch in place, while the filter helps to manage gas and odor.

Purpose

This ostomy pouch system is primarily used for individuals who have undergone surgery to create a stoma for diverting waste due to conditions such as colorectal cancer, Crohn's disease, or ulcerative colitis. The goals are to provide a reliable means for waste collection, enhance comfort, and reduce the risk of leakage and skin irritation.

Indications

• Patients with a newly created or existing stoma (colostomy, ileostomy, urostomy).
• Individuals experiencing frequent leakage or skin irritation with their current pouching system.
• Those needing an effective solution to manage stoma output and associated gas/odor.

Preparation

• Cleanse the skin around the stoma thoroughly.
• Ensure the area is dry before application.
• It may be beneficial to shave any hair around the stoma site to improve adhesion.

Procedure Description

1. Clean and Prepare Skin: Cleanse and dry the peristomal skin area.
2. Cut to Fit: Measure and cut the barrier opening to fit snugly around your stoma.
3. Application: Remove the backing from the adhesive barrier and apply it around the stoma, pressing firmly to ensure a secure fit.
4. Check the Seal: Ensure there are no wrinkles which may cause leaks.
5. Emptying: Unclasp the bottom of the pouch to empty its contents when needed, then re-clasp securely.

Tools and equipment used include the ostomy pouch system itself (which combines a barrier and a drainable pouch), and potentially a measuring guide or scissors.

No anesthesia or sedation is needed for the application of the pouch.

Duration

Application of the ostomy pouch system typically takes about 10–15 minutes.

Setting

The procedure is typically performed in the patient's home or any setting conducive to maintaining hygiene and comfort. It’s a routine self-care process.

Personnel

The patient usually performs this procedure. Initial instruction and demonstrations are provided by healthcare professionals, such as a stoma nurse specialist or a wound care nurse.

Risks and Complications

• Skin Irritation: Possible if the barrier does not fit well or if allergies to the adhesive occur.
• Leakage: Improper application may lead to leaks.
• Infection: In rare cases, infections could occur if hygiene is not maintained.

Benefits

• Effective Waste Management: Reliable containment of stoma output.
• Comfort: Improved comfort due to the secure fit and reduced frequency of changes.
• Odor Control: The built-in filter helps manage gas and odor, contributing to a better quality of life.

Recovery

• Immediate use with minimal recovery needed as this is a non-invasive procedure.
• Users should follow routine stoma care practices and monitor for any signs of skin irritation or infection.
• Regular follow-ups with a stoma care nurse may be advised to ensure ongoing effective management.

Alternatives

• Two-Piece Ostomy Systems: Pouch and barrier are separate.
• Closed-End Pouches: Suitable for less frequent changes.
• Non-Filtered Pouches: These may be simpler but less effective at gas management.

Pros of this procedure include ease of use and effectiveness in waste management. Cons could be potential skin irritation and the need for frequent replacement.

Patient Experience

• During: Patients may feel adhesive touch to their skin but no significant discomfort.
• After: Patients typically feel secure and comfortable with normal activities. Pain management is usually unnecessary but maintaining skin hygiene and monitoring for irritation is crucial.