Changes in Stoma Size during the First Three Months after Stoma Creation

Purpose: To describe how stoma size (length, width, and protrusion) changed during the first three months after stoma creation among 43 adult participants who were being followed as part of a longitudinal, descriptive, repeated measure study of stoma and peristomal complications.

Methods: At each study evaluation, the stoma was measured and pictures were taken.   Participants were assessed two to four times each (mean = 3.06) and the mean duration of follow-up was 63 days (range 13–118 days; SD 31.7). Sizes were measured using disposable stoma measuring guides with precut round openings and measurements were rounded up to the nearest 1/8-inch. Stoma protrusion was measured using a disposable paper ruler placed next to the stoma mucosa and measured to the nearest 1/8 inch at the least protruding location. The interrater reliability for stoma length (Kendall’s W= .79, p<.0001), width (Kendall’s W= .71, p<.0001), and protrusion (Kendall’s W= .94, p<.0001) were acceptable after a single 10-minute training session. 

Results: Mean width and length decreased over time, with the greatest change (0.18 inch) occurring between the first (0-20 day) and last (60 plus days) intervals. The mean stoma protrusion was 0.54 inch (range 0–1.4). There were no statistically significant differences in protrusion between the observation intervals. (F (42,3) = 1.05, p = 0.37).        

Conclusions: The changes in stoma width and length in the current study were smaller than expected, and protrusion did not change significantly.  These findings conflict with the findings of one other researcher¹. The results may have implications for patient education, and for the selection and use of stoma-care products.  The described methods of measurement of stoma dimensions (length, width, and protrusion) were reliable and could be easily included in future studies.