Purpose: The WOC nurse can be instrumental in the care of the pretransplant patient providing ostomy care to often complex stomas with high output and bowel dysfunction. When the intestines are in continuity they are at great risk for diaper dermatitis that exceeds the limits of normal diaper rash care. Wounds in this population demonstrate poor wound healing secondary to fat soluble vitamin malabsorption due to resection of bowel length.Patients often have feeding tubes with poor intestinal motility and management of leakage and preservation of skin integrity is essential.

Objective: After transplant wound care is essential to desirable patient outcomes. The current morbidity on the pediatric UNOS wait list for intestinal transplant is 40%. The use of reduced intestinal and liver grafts to expand the use of larger donors in small recipients is now common practice. Despite these reductions,the abdominal domain is insufficient to allow skin closure and results in large abdominal defects.

Outcome: Since implementing the WOC nurse position both the wound and ostomy care in the pre and post transplant population have improved. Ostomy products have been standardized focusing on ease of patient use, wear time and decreasing overall peristomal complications. Skin care of the short gut patient has been tailored to the use of specific products which have deomonstrated the best clinical outcomes. Wound care protocols have been developed in the care of post operative open abdominal wounds.