Ms Yellow* had an end colostomy formed following an emergency Hartmann’s procedure for perforation due to diverticular disease. Ms Yellow had no previous bowel related medical history, however, there was a history of falls which affected her stoma care.
Facilitating an effective seal around a parastomal hernia, simplifying stoma care and leading to peristomal skin improvements
*name has been changed to ensure anonymity
Following a prolonged hospital stay and a lengthy stay at a nursing home due to an initial poor medical condition and delayed wound healing, Ms Yellow returned home and was referred to a community Stoma Care Nurse for ongoing care.
Ms Yellow developed a parastomal hernia quite soon post-operatively. During the initial examination with a Stoma Care Nurse, it was determined that the parastomal hernia was causing complications with Ms Yellow’s stoma care, contributing to stoma pouch leakage and associated sore skin. Ms Yellow was struggling with confidence and anxiety. Usually social and outgoing, enjoying going out for lunch with friends and family and attending church, Ms Yellow had become more reclusive and had reduced these activities due to the fear of leakage.
Initial interventions involved re-sizing the cutting template of the pouch to achieve a secure seal. Ms Yellow was reluctant to change products so different stoma pouches were not introduced initially. Flange extenders were used to provide extra security with the aim of reducing the risk of leaks, increasing confidence, and reducing anxiety. Leakage continued and Ms Yellow eventually agreed to change to a soft convex stoma pouch.
The change to a soft convex stoma pouch alleviated the leaks initially, however, the leaks returned and over time continued to occur with increasing frequency. This may have been related to the sporadic functioning of the stoma as well as the increasing size of the parastomal hernia which can be more common as people age.1 Ms Yellow was reluctant to try other pouches due to her anxiety, deciding to continue use with the initial soft convex stoma pouch regardless of the regular leakage. With Stoma Care Nurse support, use of this pouch continued with regular monitoring of the peristomal skin, using additional products to manage sore skin as required.
Ms Yellow was identified as being suitable for the new Aura Plus Soft Convex pouch and was invited to try the product as part of the pre-launch evaluations. The soft, plus-shaped flange has the benefit of conforming to the uneven contours of the abdomen2 and this was considered as a factor to reduce the leakage that Ms Yellow was experiencing.
Although apprehensive, Ms Yellow agreed to try Aura Plus Soft Convex. The pouches were cut-to-fit for her stoma, the pouch was demonstrated, and a follow-up appointment was made for a weeks’ time.
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During the follow-up, Ms Yellow gave the exceptional feedback that Aura Plus Soft Convex had stopped all of her leaks. She fed back that they are ‘marvellous’ and she can’t fault them at all.
The plus-shaped flange was found to be more conformable around the parastomal hernia, facilitating an effective seal and preventing leaks. The flange didn’t crease which offered further protection against leaks, which wasn’t the case for Ms Yellow’s other pouches.
Aura Plus Soft Convex also made a positive difference to Ms Yellow’s skin. It was easier to remove, and it didn’t leave any red marks like the other pouches did. Ms Yellow explained that the other pouches caused skin-stripping, whereas Aura Plus Soft Convex was much kinder to her skin, recognising the benefits of the medical grade Manuka honey in the flange. There was a noticeable improvement to the condition of the skin around the stoma during the follow-up appointment.
Ms Yellow found that she no longer had to use flange extenders with Aura Plus Soft Convex, benefitting from the increased security of the plus-shaped flange. This made her stoma care routine much simpler whilst also providing a cost saving from reducing the amount of accessory products required. The simplification of Ms Yellow’s stoma care routine, along with the prevention of leakage, helped to reduce the risk of any further falls, as previous nighttime falls occurred when Ms Yellow was forced to get up to attend to a leaking stoma pouch, changing clothing and bedding. Ms Yellow is now able to get to the bathroom in a timely manner and attend to her stoma care needs at an appropriate time.
Aura Plus Soft Convex has made a huge positive impact to Ms Yellow’s stoma care and quality of life, providing security and preventing leaks whilst also improving the condition of the skin around the stoma.
References
- Black, P. (2000). Practical stoma care. Nurs Stand, 14(41), doi: 10.7748/ns2000.06.14.41.47.c2919. PMID: 11974240.
- Bedford, F (2022) Evolving stoma appliances to improve patient outcomes and increase stoma acceptance. British Journal of Nursing. 31 (16 Stoma Care Supplement), S18 – S23.