I have a colostomy, about 1" opening, and for 8 years I had no problem with my pouches. Then for 3 or 4 months I can't seem to have a bag on for more than a day, and there is leakage. What is deep convexity and should I have different kind of pouches that have a deep convexity? Would that help? Thank you.
Volume 57 - Issue 5 - May 2011
From the Editor: A Checklist for Quality and Progress
- 5/8/2011
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- 1766 reads
At the recent Ostomy Wound Management Editorial Board meeting, held yearly at the Spring Symposium on Advanced Wound Care, participants were asked to suggest new ongoing print and online columns that would address key issues in health- and wound care. Board members — clinicians, educators, and administrators, all literally with their fingers on the pulse of what is happening in healthcare — made quick and efficient work of providing numerous ideas that reflect both persistent and emerging concerns. With sincere gratitude to the OWM Board and in no particular order:
Wound products 101. An idea that was both championed as forward-thinking and challenged as too elementary, a column that explains the composition and use of wound care products would provide the basics with an emphasis on dressings as medical devices.
Pearls for Practice: Preventing Stage I Pressure Ulcers
- 5/8/2011
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- 2892 reads
Pearls for Practice is made possible through the support of Ferris Mfg. Corp, Burr Ridge, IL (www.polymem.com). The opinions and statements of the clinicians providing Pearls for Practice are specific to the respective authors and are not necessarily those of Ferris Mfg. Corp., OWM, or HMP Communications. This article was not subject to the Ostomy Wound Management peer-review process.
A Stage I pressure ulcer is an area of localized pressure-caused injury with nonblanchable redness of intact skin, usually over a bony prominence. Dark pigmented skin may not have visible blanching and the color may differ from the surrounding area. The area can be firmer or softer, warmer or cooler, or more painful compared to adjacent skin. These ulcers can quickly progress to cause further damage — it is important to expediently perform patient risk and skin assessments.
Nutrition 411: The Use of Cranberry Products for Urinary Tract Infection Prevention
- 5/8/2011
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- 5842 reads
Urinary tract infections (UTIs) are the most prevalent infection in long-term care (LTC), accounting for at least 40% of all infections and more than 8% of total nursing home costs.1,2 UTIs are the most prevalent source of bacteremia, the most common cause for hospital transfers, and the most common condition for which antibiotics are prescribed. Although patients usually respond to antimicrobial treatment, the recurrence rate is high and associated with side effects. It is estimated that more than 50% of elderly patients in LTC will have a recurrence, usually within 6 months, despite antibiotic therapy.3,4 The frustration of repeated cycles of antibiotic agents with diminished effects due to microbial resistance has a significant impact on the patient’s quality of life (QoL).
Continence Coach: New Subspecialty Certifies Expertise in Female Pelvic Reconstructive Surgery
- 5/8/2011
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- 1900 reads
At its March meeting, the American Board of Medical Specialties (ABMS) formally established a new subspecialty: Female Pelvic Medicine and Reconstructive Surgery.1 The new subspecialty will be administered jointly by the American Board of Obstetrics and Gynecology (ABOG) and the American Board of Urology (ABU).
My Scope of Practice: A Champion “Found” by Incontinence Care
- 5/8/2011
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- 1945 reads
If we are facing in the right direction, all we have to do is keep on walking. —Buddhist saying
When Tamara Dickinson, RN, CRN, CCCN, BCB-PMD, recently accepted the Rodney Appell Continence Care Champion Award from the National Association For Continence (NAFC), she felt vindicated. While Tamara was in nursing school, she submitted a project on the importance of being involved professionally. The theory behind her work was that everyone in nursing should strive to be as active and as knowledgeable as possible. She unexpectedly received a poor grade. Now acknowledged as an outstanding role model, Tamara has shown the merit of not only her writings, but also her laudable approach to continence care.
Incidence of Hospital-Acquired Pressure Ulcers in Acute Care Using Two Different Risk Assessment Scales: Results of a Retrospective Study
- 5/8/2011
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Abstract
More than one million people develop pressure ulcers (PU) every year in the US — a major problem that leads to increased morbidity and mortality. A hospital-acquired PU (HAPU) is defined as any ulcer noted 24 or more hours after hospital admission. The purpose of this retrospective study was to compare the incidence of HAPUs between two 1-year periods of time (March 1, 2007 through March 17, 2008 and March 18, 2008 through March 31, 2009) at an acute care facility. Records from all admitted adult medical-surgical and critical care patients along with routinely submitted quality control reports on patients who acquired PUs during hospitalization were reviewed and abstracted. A locally developed PU risk assessment instrument (SST) was used during the first time period and the Braden Scale (BS) was used during the second time period. The overall PU incidence was 368 in 41,840 patient admissions (8.80 per 1,000); 9.49 in the SST and 8.08 in the BS patient sample (P = 0.125). No significant differences in patient age, race, and PU severity or location were observed.
Using Chamomile Solution or a 1% Topical Hydrocortisone Ointment in the Management of Peristomal Skin Lesions in Colostomy Patients: Results of a Controlled Clinical Study
- 5/8/2011
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- 8289 reads
Abstract
Peristomal skin complications interfere with stoma appliance use and negatively affect patient quality of life. To find an alternative to long-term peristomal skin treatment involving corticosteroid products, a prospective study was conducted to compare the effect of a German chamomile solution to topical steroids on peristomal skin lesions in colostomy patients. Persons seeking care for the treatment of a peristomal skin lesion were assigned to a treatment regimen of once-a-day hydrocortisone 1% ointment (n = 36) or twice-a-day chamomile compress (n = 36) application. Treatments were assigned by matching patient demographic, history, and skin condition variables. At baseline, no significant differences between the variables were observed. Forty-two (42) of the 72 patients were female. Most participants had their stoma for more than 1 year (18.14 months in the chamomile and 17.69 months in the steroid group). Lesions were assessed every 3 days for a maximum of 28 days. Lesions healed significantly faster in the chamomile than in the hydrocortisone group (mean time to healing 8.89 ± 4.89 and 14.53 ± 7.6 days, respectively; P = 0.001).
Adenocarcinoma of a Colostomy Following Abdominoperineal Resection for Squamous Cell Carcinoma of the Anal Canal: A Case Study
- 5/8/2011
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- 4811 reads
Abstract
Malignant neoplasms presenting on a stoma, as well as the development of colorectal adenocarcinoma after previous treatment for squamous cell carcinoma (SCC) of the anal canal, are rare. The unique case is presented of an 81-year-old woman with parastomal bleeding and ulceration found to have a primary colorectal adenocarcinoma arising de novo on a colostomy, formed after salvage abdominoperineal resection (APR) 3 years earlier for recurrent anal SCC. This is the first reported case of a colonic adenocarcinoma on a colostomy formed after an APR for anal SCC. Although stomal neoplasia is rare, the appearance of a friable bleeding lesion on the stoma should be investigated to exclude metastatic cancer or a second primary malignancy.
May New Products and Industry News
- 5/8/2011
- 0 Comments
- 1870 reads
Study shows silver kills MRSA and other antibiotic-resistant infections
ConvaTec (Skillman, NJ) released new in vitro study results showing that a wound dressing containing ionic silver is able to kill several strains of highly resistant bacteria, commonly referred to as superbugs. The study showed that bacteria found beneath the dressing died within 48 hours. The study results were presented at the 24th Annual Symposium on Advanced Wound Care and Wound Healing Society in Dallas, TX.
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