![[ Visit WOCN Website ]](images/banner.jpg)
BACKGROUND: Stoma prolapse affects 2%-47% of individuals with ostomies (1). A prolapsed stoma occurs when the bowel telescopes through the stoma to an extent greater than anticipated (2,3). The length of the protruding bowel can vary from 2-3cm to more than 10cm. When this occurs it can be very distressing and shocking for the patient. Not usually serious, a prolapsed stoma can make pouching difficult, is susceptible to trauma, distressing, and sometimes painful (2). Stoma prolapse usually occurs with temporary loop stomas. Typical management involves support belts, which can take time to obtain, or surgical repair, which is expensive and inherently risky.
OBJECTIVE: To provide an innovative short-term management method for stoma prolapse. By maintaining a reduced stoma, this method provides improved physical comfort for the patient, and minimizes patient and family member distress. Most significantly, it decreases the chance for stomal trauma. This method can be done using products readily available in hospital, outpatient, and home care formularies.
METHOD: A prolapse cap was fashioned using a readily available one-piece convex pouch with belt loops and a belt. A convex flange with attached belt loops from a two-piece system may also be used. The prolapse cap is padded with a cotton dressing to prevent stomal injury. The cap is fitted snuggly, but not tightly over the stoma, providing support while allowing effluent to flow unimpeded from the stoma into the pouch.
RESULTS: Patients who have used this system have reported improved comfort and management until surgical revision or reversal. In cases when the prolapse is not easily reduced, the prolapse cap is not as successful.
IMPLICATIONS FOR NURSING: Other CWOC nurses at a large Midwest teaching hospital have reported the use of this method as being easy to apply, functional and comfortable for the patient.
OBJECTIVE: To provide an innovative short-term management method for stoma prolapse. By maintaining a reduced stoma, this method provides improved physical comfort for the patient, and minimizes patient and family member distress. Most significantly, it decreases the chance for stomal trauma. This method can be done using products readily available in hospital, outpatient, and home care formularies.
METHOD: A prolapse cap was fashioned using a readily available one-piece convex pouch with belt loops and a belt. A convex flange with attached belt loops from a two-piece system may also be used. The prolapse cap is padded with a cotton dressing to prevent stomal injury. The cap is fitted snuggly, but not tightly over the stoma, providing support while allowing effluent to flow unimpeded from the stoma into the pouch.
RESULTS: Patients who have used this system have reported improved comfort and management until surgical revision or reversal. In cases when the prolapse is not easily reduced, the prolapse cap is not as successful.
IMPLICATIONS FOR NURSING: Other CWOC nurses at a large Midwest teaching hospital have reported the use of this method as being easy to apply, functional and comfortable for the patient.