Name of the Procedure:

• Common Name: Drainable Ostomy Pouch
• Technical/Medical Term: Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each (HCPCS Code A4427)

Summary

A drainable ostomy pouch is a medical device used by individuals who have undergone surgery to create an opening (stoma) in the abdomen to divert waste from the digestive or urinary systems. The pouch attaches to a barrier that adheres to the skin, and the locking flange ensures a secure connection between the pouch and the barrier. The filter helps to control odor and gas buildup.

Purpose

The primary purpose of a drainable ostomy pouch is to collect waste (stool or urine) from the body through the stoma when normal elimination is not possible. This device allows people with ostomies to effectively manage waste excretion.

Indications

• Specific Symptoms or Conditions: Colostomies, ileostomies, and urostomies resulting from conditions such as colorectal cancer, Crohn's disease, ulcerative colitis, diverticulitis, bladder cancer, or traumatic injury.
• Patient Criteria: Patients who have had a stoma surgically created and require a method to collect and manage waste.

Preparation

• Pre-procedure Instructions: No specific preparatory actions are necessary for fitting the pouch but ensuring the skin around the stoma is clean and dry before attaching the barrier is critical.
• Diagnostic Tests/Assessments: No specific tests are required; however, regular follow-ups with a healthcare provider are recommended to monitor the stoma and surrounding skin's condition.

Procedure Description

1. Cleaning: Clean the stoma and surrounding skin with water and mild soap.
2. Barrier Application: Attach the skin barrier around the stoma. The barrier should fit snugly to prevent leaks.
3. Pouch Attachment: Connect the pouch to the barrier using the locking flange mechanism.
4. Filter Adjustment: Ensure the filter is in place to control odor and gas.

• Tools/Equipment: Ostomy pouch, skin barrier with locking flange, scissors (for trimming the barrier to fit), adhesive remover, stoma powder, and skin protective wipes.
• Anesthesia/Sedation: Not applicable.

Duration

The fitting process generally takes about 10-20 minutes.

Setting

This procedure is typically performed at home by the patient or a caregiver, following initial instruction and training provided in a hospital or outpatient clinic.

Personnel

• Healthcare Professionals: Ostomy care nurses, wound care specialists, and occasionally the surgeon or primary care physician in case of complications or initial training.

Risks and Complications

• Common Risks: Skin irritation, leakage, and odor.
• Rare Risks: Peristomal skin infections, stoma retraction or prolapse, and allergic reaction to adhesive materials.
• Management: Proper skin care, regular monitoring, and consulting healthcare professionals for persistent issues.

Benefits

• Expected Benefits: Effective waste management, improved quality of life, reduced skin irritation with proper use, and secure attachment of the pouch.
• Timeframe for Benefits: Immediate upon correct application.

Recovery

• Post-procedure Care: Regular hygiene maintenance around the stoma, frequent pouch changes as recommended.
• Expected Recovery Time: Continuous use; requires adaptation period and routine care.
• Restrictions/Follow-Up: Avoid heavy lifting and activities that may dislodge the pouch; periodic follow-up appointments with healthcare providers.

Alternatives

• Other Treatment Options: One-piece ostomy systems, closed-end pouches, and different barrier types.
• Pros and Cons: Single-piece systems may be simpler but less flexible; closed-end pouches need to be replaced more frequently. The two-piece system provides a balance of flexibility, security, and ease of use.

Patient Experience

• During Procedure: Minimal discomfort; the process is straightforward after proper training.
• After Procedure: Some patients may experience initial discomfort. Regular use typically leads to familiarity and comfort in managing the pouch. Pain management may involve over-the-counter analgesics for skin irritation, if necessary.