Name of the Procedure:

Ostomy Pouch Application
Common name: Ostomy pouch
Technical term: Ostomy pouch, drainable, for use on barrier with non-locking flange, with filter (2 piece system), each (HCPCS A4425)

Summary

An ostomy pouch is a medical device used to collect waste from a surgically created opening (stoma) in the abdominal wall. This specific type includes a drainable pouch designed for use with a barrier that has a non-locking flange and a filter to help manage odor. It is part of a two-piece system where the barrier and pouch are separate but attach to each other.

Purpose

The ostomy pouch is used to manage waste for individuals who have had surgery to create a stoma due to conditions like colorectal cancer, Crohn's disease, or ulcerative colitis. The main goal is to provide a comfortable, secure way to collect waste and manage the stoma, thereby enhancing the patient's quality of life.

Indications

• Patients with a surgically created stoma due to colorectal cancer, Crohn's disease, ulcerative colitis, or other conditions.
• Individuals requiring a practical and hygienic method for waste collection.
• Patients needing a drainable pouch system with a filter to manage odor.

Preparation

• Patients should follow their healthcare provider's instructions, which may include cleaning the stoma and surrounding skin.
• No specific fasting or medication adjustments are generally needed.
• The stoma and skin barrier should be assessed to choose the appropriate size and type of pouch.

Procedure Description

1. Clean and dry the skin around the stoma.
2. Fit the barrier with the non-locking flange around the stoma.
3. Attach the drainable pouch to the barrier, ensuring the flange fits securely.
4. Ensure the pouch's filter is functioning and the pouch is properly sealed.
5. Educate the patient on how to open the drainable pouch and empty it as needed.

Tools and Equipment:

• Barrier with non-locking flange
• Drainable ostomy pouch with filter (2 piece system)
• Cleaning supplies

No anesthesia or sedation is required.

Duration

The application of the pouch typically takes about 10-15 minutes.

Setting

This procedure can be performed at home or in outpatient settings such as a clinic or hospital.

Personnel

Typically, no healthcare professional is required for each application once the patient is trained, but initial training may be provided by a nurse or ostomy specialist.

Risks and Complications

• Skin irritation or infection around the stoma
• Leakage or improper fitting causing discomfort
• Allergic reactions to the materials used

Management usually involves addressing the specific cause (e.g., using different materials, improving skin care).

Benefits

• Effective and hygienic waste collection
• Reduced risk of odor due to the filter
• Improved comfort and quality of life Benefits can be realized immediately after the pouch is correctly applied.

Recovery

• Immediate return to normal activities once proficient with the application.
• Ongoing care involves regular emptying and replacing pouches as needed.
• Follow-up appointments may be necessary to address any complications or for routine check-ups.

Alternatives

• Single-piece ostomy systems (where the barrier and pouch are combined)
• Different types of pouches (non-drainable, with different types of flanges)

Pros and Cons:

• Single-piece systems may be simpler but less customizable.
• Non-drainable pouches might need more frequent changes but could be preferred for certain lifestyles.

Patient Experience

• Initially may feel awkward but becomes routine with practice.
• Minimal discomfort when applied correctly.
• Pain management is generally not needed, but skin care is important for comfort.