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Ostomy Pouch
Ostomy Wound Management on the Web is a comprehensive resource for clinical information on wound care as well as Ostomy Pouch. We hope the articles below provide timely information for your practice.
New HCPCS Codes for Ostomy Supplies
Billing for as many as six HCPCS codes may now be necessary for a single pouch. Medicare fee schedule amounts are to be issued in mid-March. No additional medical justification (documentation) will be required for coverage and payment of the "addition to ostomy pouch" feature codes.
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An Evaluation of the Canadian Ostomy Assessment Guide
The Canadian Ostomy Assessment Guide was developed to assist in the selection of appropriate pouching systems by nonspecialized nurses. Since its development in 1999 until December 2001, 4,500 nurses across Canada have been trained to use the Canadian Ostomy Assessment Guide in their clinical practice. Because the effects of its use had not been studied, a prospective, cohort study was conducted to assess the effect of the guideline on pouching system wear time and cost; peristomal skin condition; patients' perceptions of their ostomies, pouching system, and sense of well-being; and usefulness of this generic clinical tool. Registered nurses were trained to use the Canadian Ostomy Assessment Guide and study data collection sheets, including the Quality of Life questionnaire. All patients were assessed three times and an end of study evaluation was completed following the third and final visit. Fifty patients (26 men, 24 women) were enrolled and completed the study. Following implementation of the Canadian Ostomy Assessment Guide, appliance wear time increased an average of 1.5 days (P < 0.001) and pouching system costs decreased (mean $1.80 Canadian/day, P < 0.05). No significant differences in peristomal skin status were observed, but patient sense of well being and security increased significantly during the study (P <0.05). The Canadian Ostomy Assessment Guide was rated as an extremely useful clinical tool by 67% of the nonspecialized nurses who used it. Ostomy patients experience major benefits when nonspecialized nurses use this generic clinical tool to select an appropriate pouching system.
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Medicaid: For Want of an Ostomy Pouch
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Medicaid: For Want of an Ostomy Pouch
For want of a nail, the shoe was lost; for want of a shoe the horse was lost; and for want of a horse, the rider was lost, being overtaken and slain by the enemy ? all for want of a horseshoe nail. ? Benjamin Franklin
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Colocutaneous Fistula Management in a Dehisced Wound: A Case Study
A fistula is an abnormal opening between two or more organs or structures. Wound drainage containment is a key component of nonsurgical fistula management and may include pouches, skin barriers, transparent dressings, troughing procedures, saddle bagging, bridging, and condom and suction catheters used in combination with complex or routine pouching. Following extensive abdominal surgery, the wound of a 50-year-old woman dehisced and a colocutaneous fistula formed inside the wound. The wound containing the fistula, which was draining liquid stool, was too large for existing commercial pouching systems. When initial management efforts, including negative pressure wound therapy, failed to achieve containment goals, clinicians adapted the negative pressure wound therapy dressing to surround the fistula, which helped facilitate therapy while providing a platform for an ostomy appliance to contain the fistula drainage. The system was changed every 2 days until discharge. The wound and fistula management combination improved patient comfort and mobility, facilitated healing, and reduced patient dietary restrictions.
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May 2004 New Products
For more information, please call (904) 261-2169, or visit www.zassimedical.com. - OWM Cream and gel treat dry and oily skin types Healthpoint, Ltd. (Fort Worth, Tex.) For more information, visit www.healthpoint.com. - OWM Recreational use stoma belt conceals and protects ostomy pouch Advent Product Development, Inc. (Pawleys ...
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Randomized Crossover Comparison of Adhesively Coupled Colostomy Pouching Systems
Ostomy pouching systems affect well being and quality of life, making selection of the appropriate system a key element of ostomy care. Several innovative adhesively coupled, two-piece systems are on the market. They feature flexible low profiles, allowing pouch removal/replacement without changing the skin barrier or wafer. This facilitates inspection or pouch changes without disrupting peristomal skin. Because few controlled trials compare pouching system effectiveness, a prospective, randomized open-label, crossover study was conducted. Under the supervision of ostomy care nurses in six outpatient clinics in Germany, clinical performance of and patient preferences for two adhesively coupled, closed-end pouching systems were compared during normal use. One is a gelatin/pectin-based skin barrier sealed to the pouch with a company-specific adhesive coupling technology (System E); the other, a grooved base plate wafer adhesive pouch coupling system (System F). Seventeen attributes and seven end-of-study measures that included comfort, flexibility, wear time, ease of removal, and overall performance were assessed. Informed, consenting participants were randomly assigned to use one system for five skin barrier/wafer changes or up to 15 days and subsequently switched to the alternative system for a similar period. The 39 participants used a total of 1,645 pouches and 342 skin barriers. All were found safe as determined by incidence and nature of the reported peristomal skin problems, subject withdrawals, and adverse events for both systems. However, System E provided longer pouch wear times (P < 0.01). End-phase ratings favored System E on 10 of the 17 attributes (P <0.04) and System F on none. More participants preferred System E on all seven end-of-study measures, five significantly (comfort, flexibility, wear time, ease of removal, and overall performance; (P <0.02). These participant-reported, ostomy-related outcomes underscore the importance of product evaluation and selection for persons with an ostomy.
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A One- or Two-Piece Pouching System?
Subcategories within these two classifications include: * type of pouch (ie, closed-end, drainable, or urinary; transparent or opaque) * type of skin barrier (ie, standard, extended-wear) * stomal opening (ie, pre-cut or cut-to-fit) * depth of convexity (ie, flat, convex) * method in ...
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A Pressure Ulcer and an Ostomy: An Unlikely Combination?
- Gwen B. Turnbull, RN, BS, ET Earlier this year, the National Pressure Ulcer Advisory Panel (NPUAP) updated its pressure ulcer definitions and staging system. Pressure ulcers in the peristomal area are not uncommon. Poorly sited stomas also are prone to pressure necrosis.
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The Convexity Controversy
Shortcomings of Convex Products Patients and clinicians report that most convex products are too rigid to fit into deep skin folds or crevices around the stoma. Because not all supplemental products are precut, they often must be customized by the patient to meet individual needs to build up an effective depth of convexity. Data gathered during patient assessment7 ...
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