Convexity: Uncovering the Evidentiary Gaps

Purpose:  The objective of this poster is to examine some of the evidence that supports a clinician’s understanding of convexity products and their application in ostomy care.  Areas that will be explored include patient assessment, convexity terminology, indications and complications.

Statement of problem:Comprehensive assessment guidelines for patients requiring convexity are essentially non-existent.  Clinical indications and contraindications based on evidence are lacking and frequently anecdotal.  Today, a vast array of convex product solutions is available to the clinician, challenging the ability to make quick and easy decisions (1,4).  Clinicians will intuitively select a convex product for a clinical application based on its particular depth, shape or properties but not always understand the basis for their selection criteria nor be able to clearly articulate this choice. A more cohesive approach to convex product and patient assessment is necessary to assist clinicians (1).

Design:  A comprehensive literature review was conducted to examine the availability of current methodologies, tools, and information for clinicians to understand and utilize convex skin barriers for patients.

Conclusions:  The literature review revealed a fragmented array of citations related to convexity.  There is a lack of support for evidence-based practice regarding convexity product descriptions and application guidelines (2).  Most convexity choices appear to be based on the clinician experience over time using trial and error to determine clinical application (3).  Current descriptors used for convexity products are creating confusion, and a standardized approach to product nomenclature does not exist (1).  The development of assistive clinical practice guidelines in conjunction with further research is required (1,4).