Name of the Procedure

Common Name: Ostomy Pouch Change
Technical/Medical Term: Ostomy pouch, closed; for use on faceplate (HCPCS Code: A5053)

Summary

An ostomy pouch change involves replacing an existing ostomy pouch with a new, closed-end pouch. This pouch collects waste from the body via a stoma, an opening on the abdomen. The new pouch attaches to a faceplate (also known as a flange or wafer) that adheres to the skin around the stoma.

Purpose

Medical Conditions: Used by patients with colostomies or ileostomies due to conditions such as colorectal cancer, inflammatory bowel disease (IBD), diverticulitis, or trauma.
Goals/Expected Outcomes: Ensure proper waste management, maintain hygiene, prevent skin irritation, and enhance quality of life.

Indications

Symptoms/Conditions: Patients with a stoma who need to manage waste output.
Criteria: Patients with existing faceplate systems who require frequent pouch changes.

Preparation

Pre-Procedure Instructions:

• Clean skin around the stoma.
• Gather all necessary supplies: new pouch, adhesive remover, skin barrier wipes, and a washcloth. Diagnostic Tests: None required.

Procedure Description

1. Gather Materials: New closed-end pouch (A5053), adhesive remover, skin barrier wipes, and other cleaning supplies.
2. Remove Old Pouch: Carefully peel off the existing pouch from the faceplate.
3. Clean Stoma Area: Use a washcloth and warm water to clean the area around the stoma.
4. Prepare Skin: Apply skin barrier wipes around the stoma to protect the skin.
5. Attach New Pouch: Align the new pouch opening with the stoma and press firmly onto the faceplate until secure. Tools/Equipment: Ostomy pouch, adhesive remover, skin barrier wipes.
   Anesthesia/Sedation: None required.

Duration

Typically, the procedure takes about 10-15 minutes.

Setting

Performed at home or in a clinical setting such as an outpatient clinic or a doctor's office.

Personnel

Generally self-administered by the patient or with the help of a caregiver. A nurse or ostomy specialist can assist as needed.

Risks and Complications

Common Risks:

• Skin irritation around the stoma
• Leakage or poor adhesion of the pouch Rare Risks:
• Stomal blockage or infection Complications Management: Proper skin care and regular pouch changes can mitigate most risks.

Benefits

Expected Benefits:

• Improved hygiene
• Comfortable waste management
• Enhanced mobility and freedom Time to Realization: Immediate upon successful pouch change.

Recovery

Post-Procedure Care:

• Regular monitoring of skin around the stoma
• Immediate use of the new pouch Expected Recovery Time: No recovery time needed; normal activities can be resumed immediately.
  Restrictions/Follow-Up: Follow-up appointments only if complications arise.

Alternatives

Other Treatment Options:

• Reversible stoma closure if applicable
• Use of a different type of ostomy pouch system (e.g., drainable pouches) Pros and Cons:
• Reversible stoma closure: Eliminates need for a pouch but not suitable for all patients.
• Different pouch systems: May offer ease of use or better comfort, but some systems require more frequent changes.

Patient Experience

During Procedure:

• May feel mild discomfort during cleaning and application of the pouch. After Procedure:
• Increased comfort and security.
• Effective waste management. Pain Management/Comfort Measures:
• Use of adhesive removers and skin barrier wipes for irritation prevention.