Stoma Siting - Or How to Place the Stoma

A common complication of stoma is a poor stoma siting. This means that a stoma is placed in a location that is rather inaccessible and this makes cleansing and ordinary hygiene very difficult to perform. Pouching system management in this situation becomes a nightmare.

Poor stoma siting generally refers to a stoma sited close to prominent bones, in the vicinity of old scars or the umbilicus. Other poor stoma siting is at the level of the umbilicus and withing a skin fold.on the main incision, or in deep peristomal creases.

The best way not to have this kind of unpleasant problems is to talk with your doctor and your nurse prior to the surgery and settle a place to put the stoma so that it will not cause any problems.
The basic rules for stoma site selection are to place the stoma through the rectus muscle, at the apex of the infra-umbilical fat mound, at least 4 inches from the planned incision, and far enough from umbilicus, bony prominences, scars, incision site, or skin creases to allow proper application and adherence of the pouching system.

The most common problem that appears because of poor stoma siting is leakage. The most common problem that appears because of poor stoma siting is leakage of the pouching system. And this tends to get pretty irritating. In tins case you will need to see the doctor to have him correct the defect by matching the pouching system to your contours. He will probably use a flexible pouching system that will ensure a very flexible abdominal movement.

Scars and other skin damage or problems will surely harden a good stoma siting. This can be easily repaired by filling these with barrier paste or moldable barrier wedges or strips will help prevent leakage beneath the pouching system

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