Novel stoma appliances to minimise complications and improve patient outcomes

Being a community bladder and bowel nurse on a Crown dependency island with around 250 ostomates brings its own challenges. Ostomates on the Island suffer the same complications and frustrations as ostomates do worldwide. Evidence suggests that 20% of stoma patients found the anxiety of having a stoma affected their personal and work life (Black and Notter, 2021). Stoma-related complications such as parastomal hernias, stenosis, prolapse, and retraction are thought to affect up to 70% of ostomates (Ambe et al, 2018), with many of these issues leading to leakage and sore peristomal skin, which are complications in their own right and which can have a subsequent effect on the ostomate's quality of life.

In the author's day-to-day practice, the most frequent request for stoma advice and support is from ostomates who have sore skin or who have been struggling with leaks. The initial assessment involves the size and position of the stoma and the condition of the abdominal wall. Often the stoma has not been measured for some time and the flange no longer fits around it effectively. There are many causes of leakage and sore peristomal skin, including suboptimal product selection. Local ostomates do not get to see new products as easily as their mainland counterparts, due to there being fewer open days and less opportunity for stoma company territory managers to visit. Often patients try to manage leakage with a variety of samples of devices and skin care products that they have obtained themselves from the internet or by contacting a stoma care company.