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 51 - Issue 12 - December, 2005
Guest Editorial: Challenge to Change: CMS Interpretive Guidance — Urinary Incontinence and Indwelling Catheters
- 12/1/2005
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This issue of Ostomy Wound Management includes articles on bladder and bowel clinical practice. Offered are a study on the barrier function/skin hydration capabilities of skin protectants, a study of barrier properties that may compromise diaper use, a review of the emotional impact of urinary diversions, a discussion of a new technology for containment (the anal bag), and a case study of a surgical approach to chronic constipation. Much of this information is especially timely because of the impact of the Centers for Medicare and Medicaid Services’ (CMS) new Investigative Guidance Ta
Life is about Choice
- 12/1/2005
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Life is a series of decisions. We have a choice in life regarding almost every aspect, down to the smallest details. We make choices about our education, vocation, life partner, whether to have children, and other significant life-altering events. We choose our friends, the model of the car we drive, the clothes we wear, the television programs we watch, and even the type of food we eat. Sickness and disease prevent us from having control over things we have traditionally taken for granted, often leading patients to say, “I have no choice in the matter,” when it comes to illness or surgery
Oversight, Outcomes, and Omission
- 12/1/2005
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GAO Recommends More Stringent Oversight of Medical Suppliers
Last year, the Centers for Medicare and Medicare Services (CMS) paid medical equipment suppliers $8.8 billion. Of those expenditures, an estimated $900 million was improperly paid to suppliers of durable medical equipment (DME), prosthetics, orthotics, and medical supplies — often due to supplier fraud. For many years, the CMS has contracted with the National Supplier Clearinghouse (NSC) to perform watchdog services to verify that suppliers adhere to Medicare’s 21 supplier standards before they are eligible t
One-Step Care Yields Big Results
- 12/1/2005
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Angela Box Peterson, RN, WCC, began her career in acute care nursing, working on med-surg, ICU, ER, and ambulance units. She moved into management, coordinating the staffing and care for a vent-dependent pediatric patient and serving as a Public Health Nurse, a Supervisor, and a Quality Assurance Coordinator in home health and an Assistant Director of Nursing for a nursing home, among other assignments. But she didn’t realize how happy she could be until she became immersed in wound care. Her pursuits and passion enabled her to find an effective approach to skin care in patients with fecal i
Survey Indicates Lack of Incontinence-Related Communication/Knowledge
- 12/1/2005
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- 2973 reads
Clinicians and caregivers face the challenge of protecting their patients against skin breakdown that can lead to perineal dermatitis and pressure ulcer development. Between 1.5 and 3 million adults suffer from pressure ulcers in the US at a cost to healthcare of close to $1.6 billion annually.1,2 Often, these wounds are related to the effects of incontinence.
An incontinence care opinion poll was conducted at the 37th Annual Wound, Ostomy and Continence Nurses Society conference, held June 12–16, 2005, in Las Vegas, Nev. Of the 1,318 registered attendees, 230 participated i
The Legal Aspects of Incontinence
- 12/1/2005
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- 3882 reads
Almost all elderly nursing home residents (approximately 97%) need assistance in performing at least one activity of daily living (ADL) — activities that include the ability to bathe, dress, eat, transfer from bed to chair, and use the toilet. In addition, about 50% of residents have an incontinence problem that may require diapering, close supervision, or toilet training.1
Yet despite resident needs, on some occasions nursing home staff evaluators note that staff are not turning and repositioning residents for hours at a time, not cleansing residents after incontinence epi
Medicare Payment System for Urological Supplies
- 12/1/2005
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Previous “Payment Perspective” columns review the Medicare payment systems for wound care drugs, dressings, and biologics. To coordinate with the theme of this issue, Table 1 was created to depict how various Medicare payment systems handle urological supplies throughout the continuum of care.
A Controlled, Three-Part Trial to Investigate the Barrier Function and Skin Hydration Properties of Six Skin Protectants
- 12/1/2005
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The superficial layer of the skin, the stratum corneum, provides a protective barrier. This layer consists of keratin-filled corneocytes organized in a matrix of highly ordered multilamellar lipid sheets, described as a brick wall-like structure (the corneocytes forming the bricks and the intercellular lipids representing the mortar).1 If the stratum corneum breaks down, the barrier function of the skin is impaired, a risk factor associated with the formation of pressure ulcers.2,3
Factors that can impair barrier function include irritants, moisture, abrasion, and b
The Anal Bag: A Modern Approach to Fecal Incontinence Management
- 12/1/2005
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Fecal incontinence is an expensive and potentially dangerous pathologic condition, with severe consequences in terms of contamination, infection, and impending risk of skin ulceration, especially in long-term bedridden patients. Prevalence studies of fecal incontinence in the general population are rare.1,2 Among younger age groups (<65 years), the prevalence of fecal incontinence has been estimated at 0.7%3 and 0.9%.4 In people 60 years or older, prevalence estimates are higher, ranging between 3.1% and 8.2%, but the sample sizes are not large enough to draw
Assessment of Diaper-Clogging Potential of Petrolatum Moisture Barriers
- 12/1/2005
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- 7103 reads
Incontinence is both a prevalent1,2 and costly3 condition among older adults that is often managed with disposable and reusable absorbent incontinence products such as pantiliners, protective underwear, and adult briefs.4,5 Individuals residing ininstitutions or long-term care settings tend to have more severe urinary incontinence than community-dwelling individuals, necessitating use of highly absorbent incontinence products.6 Unlike reusable incontinence products, disposable adult briefs are constructed of specialized multiple layers that have a su
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