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Stoma care - 1(a) Cutting a template

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VOL: 97, ISSUE: 12, PAGE NO: 43

CHRIS METCALF, GASTROENTEROLOGY ENDOSCOPY NURSE SPECIALIST, WEST HERTS NHS TRUST, WATFORD GENERAL HOSPITAL.

A variety of conditions may necessitate the formation of a colostomy or an ileostomy: carcinoma, ulcerative colitis, Crohn's disease, diverticular disease, colonic obstruction, bowel ischaemia, anorectal incontinence, trauma and radiation damage.

A variety of conditions may necessitate the formation of a colostomy or an ileostomy: carcinoma, ulcerative colitis, Crohn's disease, diverticular disease, colonic obstruction, bowel ischaemia, anorectal incontinence, trauma and radiation damage.

Patients have a wide range of appliances from which to choose. These are made of laminated plastic and are lightweight, waterproof and odourproof. Some closed pouches (see below) are also toilet disposable.

There are two types of appliances for colostomies and ileostomies: a non-drainable (closed) pouch or a drainable (open-ended) one. Both are available as a one-piece system - where the skin-protective and pouch are all one unit - or a two-piece system where there is a separate baseplate onto which a pouch is usually clipped.

This Part illustrates two methods of cutting a template for a one-piece bag. Cutting a template is usually carried out while changing an appliance (see Practical Procedures, April 12). A template should be made during the first pouch change so ensuring that the patient and other nurses have a pattern of the correct stoma size for subsequent pouch changes. Regular re-measuring is important postoperatively as the stoma tends to reduce in size as swelling resulting from surgery reduces.

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