Key Findings from the 2015 International Consensus Congress on the Use of Convexity

Problem:   There is a shortage of rigorous evidence about the use of convexity; few studies have been conducted and existing reports are primarily reviews and case studies¹. Thus, the level of evidence available for convexity is low.

Purpose: To establish consensus from a cross-section of international stoma care experts about assessment and use of convexity for ostomy care in adults. These statements would provide a level of evidenced-based information not available prior to the time of the consensus congress.

Methods: Using structured processes as outlined by Murphy et al², expert stoma care nurses from nine countries convened to participate in a consensus development congress led by an expert facilitator.  Panelists prepared for the congress by reviewing a comprehensive literature summary about convexity and researching their own country’s literature for additional references. At the congress, panelists used electronic pads to vote sequentially on structured statements, discussing key points of disagreement where needed, and editing the statements when possible to come to agreement.  Panelists also had opportunity to create new statements and present them to the panelists for their opinion / voting. Statements accepted were those on which 80% or more of the panelists agreed within three or fewer “rounds” of discussion, revision, and voting.

Results: The panelists reached agreement on 26 definitive statements about convexity. In this presentation we will share their statements about indications for use of convexity, considerations for assessment and re-assessment, and when soft or firm convexity may be most appropriate.  

Conclusion: Using a structured, guided method of consensus development, global stoma care nurses provided clarity about expert opinion on use of convexity. These key statements provide evidence for use in practice, policy and education.