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 53 - Issue 2 - February, 2007
A Timely and Timeless Event
- 2/1/2007
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The National Pressure Ulcer Advisory Panel (NPUAP) is an independent, not-for-profit professional organization dedicated to promoting evidenced-based care for pressure ulcers. Formed in 1987, the NPUAP is composed of a multidisciplinary team of pressure ulcer experts from a variety of healthcare disciplines who share a commitment to pressure ulcer prevention and care. Every 2 years since 1989, the NPUAP has held a consensus conference to enhance awareness of the scope and weight of the pressure ulcer problem and to discuss timely relevant issues.
Snow Birding: Traveling with an Ostomy
- 2/1/2007
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February is the month when Old Man Winter plays hardball. Many people living in northern climates choose this time of year to pack up and travel south to escape cabin fever, the cold, the wind, gray skies, and a depressive condition called Seasonal Affective Disorder (SAD).1 People living in more temperate climates refer to these flocks of northern migrators as “snow birds.” This month’s column provides some helpful hints to share with patients with an ostomy who may be planning a snow-bird getaway this month.
At the Center of a Center of Excellence
- 2/1/2007
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Inspired by the final words of her father and later validated by her dying brother’s support for what he called “her gift,” Cathleen (“Cathy”) Markley, RN, BS, CWOCN, pursued a career in nursing and nurtured an interest in patients with complex wounds. Now the Wound Care Nurse at Select Specialty Hospital’s Camp Hill and York (Pennsylvania) long-term acute care (LTAC) facilities, Cathy has overseen so much growth in her practice that her “hospitals within hospitals” are moving to a free-standing facility in 2008. Her devotion to wound care helped Select Specialty Hospital-Central Pennsylvania earn a “Center of Excellence” award for wound treatment – parent company recognition from a corporation that operates 93 LTAC hospitals and is not frivolous about its acknowledgment program.
Evaluating the Implementation and Outcomes of the Saskatchewan Pressure Ulcer Guidelines in Long-Term Care Facilities
- 2/1/2007
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Index: Ostomy Wound Manage. 2007;53(2):28-43.
Introduction
Pressure ulcers represent a burden of illness for patients and residents in a variety of healthcare settings in Canada as well as a considerable cost to the healthcare system. Few studies have measured the prevalence of patients with pressure ulcers in Canada. A literature review by Woodbury and Houghton1 estimated that the prevalence of pressure ulcers in Canada is 15% for community care, 20% for mixed healthcare settings, 25% in acute care, and 30% in non-acute care (inpatient or institutional) settings.
One strategy for improvement has been to translate best-practice knowledge into evidence-based best practice guidelines. Although evidence-based pressure ulcer guidelines exist, many healthcare facilities do not use a standardized approach such as a best practice guideline to prevent and treat pressure ulcers.2-5
A Prospective, Descriptive Pressure Ulcer Risk Factor and Prevalence Study at a University Hospital in Turkey
- 2/1/2007
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Index: Ostomy Wound Manage. 2007;53(2):44-56.
Introduction
Despite advances in medicine, surgery, and nursing care, pressure ulcers continue to be a common healthcare problem among hospitalized patients,1,2 causing pain, suffering, and frustration. Pressure ulcers increase the workload of healthcare clinicians and as a consequence increase healthcare costs dramatically.3,4 Identifying individuals at risk may help reduce pressure ulcer prevalence.
Numerous pressure ulcer risk factor and prevalence studies have been conducted in European countries and the US. In Turkey, however, such studies are limited and no national or local database of patient records regarding pressure ulcer prevalence or incidence rates exists nor are guidelines available for developing an assessment tool.
Intraoperatively Acquired Pressure Ulcers: Are There Common Risk Factors?
- 2/1/2007
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Index: Ostomy Wound Manage. 2007;53(2):57-69.
Introduction
Descriptive studies1-4 related to contributory factors in pressure ulcers conducted in long-term care and acute care settings have led to the development of many well-known skin risk assessment tools (ie, Gosnell’s Assessment of Patient Potential for Pressure Ulcer, Braden Scale of Pressure Ulcer Risk Assessment, the Norton Score, Abruzzese's Modified Assessment of Decubitus Ulcer Potential Tool). Several descriptive studies5-10 examining factors associated with pressure ulcer development in the surgical population have demonstrated some consistency among variables associated with pressure ulcer formation and documented that even patients with a low assessment tool-based risk score may develop a pressure ulcer within the operative period.11-13 However, no specific skin risk assessment tool for the intraoperative patient population is available.
Pressure Ulcers and Other Chronic Wounds in Patients with and Patients without Cancer: A Retrospective, Comparative Analysis of
- 2/1/2007
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Index: Ostomy Wound Manage. 2007;53(2):70-78.
Introduction
More than 10 million Americans are living with cancer.1 Five years after diagnosis, 64% of individuals with cancer are alive; 61% of cancer survivors are 65 years or older. One in every six Americans 65 years or older is a cancer survivor.1 Earlier detection, better treatment, and a growing population of elderly have increased the number of people living with and surviving cancer. For practitioners and researchers concerned with chronic wound care, the implications of these statistics and characteristics are obvious: a growing population of older cancer survivors with comorbid conditions is living longer – a population that may be at increased risk for skin breakdown and the development of chronic wounds. Unfortunately, the risk of skin breakdown is frequently exacerbated by inadequate planning, education, and guidance as patients move from and are lost in the transition from cancer treatment to survivorship.2 Ideally, during-treatment and after-treatment alternatives should be evidence-based.
The body of evidence regarding chronic wounds is large and growing. However, such growth is not represented in the literature on wound healing in patients with cancer.3 Some studies have focused on skin cancer and skin toxicity related to treatment4,5; others describe certain high-risk/high-management patients (eg, skin care in radiation therapy,6 malignant or fungating wounds,7-9 breast cancer survivors with lymphedema,10 and persons receiving palliative care11).
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