Ms Orange* is a 78-year-old lady who had an end-colostomy formed in 2020 following a total abdominal hysterectomy. Ms Orange has a large, rounded stomach where the stoma is poorly spouted and flush to the skin. When sat upright, the stoma sits within a recessed area, and this can be exaggerated by movement.
Providing gentle support for a flush stoma and a rounded abdomen
*name has been changed to ensure anonymity
Ms Orange had been using the same soft convex stoma pouch since her surgery, but unfortunately had experienced breakdown of the mucosal edge of the stoma, ulcerated peristomal skin and pouch discomfort as the pouch dug into Ms Orange’s leg and groin area. Ms Orange used stoma washers and a protective skin-barrier to manage these complications which led to improvements, although there was a reluctance to stop using those products after said improvements which added complexity to Ms Orange’s stoma care routine.
Ms Orange has a past medical history that includes macular degeneration, cerebrovascular accident, and fibromyalgia. These conditions have left Ms Orange with reduced mobility and unable to care for herself. Her husband is now her main carer; he carries out all personal care including stoma care. Pouches are normally renewed daily, but this could alter depending on bowel movements.
Following a review by her Stoma Care Nurse, Ms Orange was recommended the new Aura Plus Soft Convex pouch. The aim was to provide security against leaks with the soft convex plus-shaped flange, with a flexible and conformable flange to enable an optimal fit around Ms Orange’s rounded stomach whilst also reducing the risk of any pressure related skin injury. It was also to promote healthy skin around the stoma with the inclusion of medical-grade Manuka honey in the hydrocolloid flange.1
After agreeing to try it, Ms Orange evaluated the product. The product was demonstrated to Ms Orange and her husband by her Stoma Care Nurse. During this time, it was explained that the soft convexity is designed to apply gentle pressure to help bring the stoma out into the pouch, reducing the risk of leaks by encouraging output to fall into the pouch. It was advised to stop the use of the stoma washer, as that should no longer be necessary due to the support offered by Aura Plus Soft Convex. The benefits of Manuka honey were also explained, that it can be used for treating local wound infection, reducing bacteria levels, and reducing inflammation2 and that it may help promote healthy skin around the stoma. This meant that the use of any further protective skin barriers should also be unnecessary.
Sensitive Content
This photo contains sensitive content which some people may find offensive or disturbing.
See Content
Sensitive Content
This photo contains sensitive content which some people may find offensive or disturbing.
See Content
The pre-evaluation photograph was taken prior to beginning evaluation period of 7 days. There is visible irritation on the left side of the stoma, where the skin appears dry and fragile. It was thought that this irritation was pressure related, as there was no previous reports of leaks.
Ms Orange was reviewed by her Stoma Care Nurse the following week. She was very positive about Aura Plus Soft Convex, explaining that it was much better than the soft convex product that she had used since having her stoma formed. It was a better shape for her body, the drainable outlet was more robust and discrete, the pouch didn’t dig into her skin and there was a noticeable improvement to her peristomal skin within the week.
The post-evaluation photograph was taken after 7 days. It was observed that the peristomal skin was less irritated and was no longer dry in affected areas. The redness around the mucosal edge reduced greatly.
Aura Plus Soft Convex was a suitable choice for Ms Orange. It provided the right level of convexity, preventing leaks without causing any trauma or damage to the surrounding skin. The plus-shaped flange moulded well to the contours of Ms Orange’s rounded abdomen and remained secure regardless of the flush and recessed nature of the stoma. The pouch and outlet also offered superior levels of comfort compared to Ms Orange’s previous pouch, no longer digging into her skin. The security and skin health offered by Aura Plus Soft Convex meant the use of additional washers and protective skin barriers was no longer needed.
References
- Evans, M. (2018) The use of manuka honey within stoma care to maintain peristomal skin integrity: the ostomates perspective. World Council of Enterostomal Therapists Journal. 38 (2): 40
- Oxford Health NHS Foundation Trust. (2015). Medical honey simplified. Retrieved from https://www.oxfordhealth.nhs.uk/wp-content/ uploads/2015/08/Medical_Honey_Simplified_-_Patients-leaflet.pdf