Should Protocols exist for the use of Convex products?

Convex products have been commercially available for decades. In the early 1990’s the very first integral convex appliance was developed, this product revolutionised stomal management. Since then there has been a myriad of integral convex appliances launched into the marketplace of varying depths and degrees of flexibility. Many specialist and non-specialist nurses are being challenged to make critical decisions relating to convexity usage often without the clinical knowledge or practical experience to do so. Is it time that specialist nurses developed some best practice guidelines to ensure stoma care patients receive optimum care?

Aim: To explore the need for nursing protocols that can be used to guide best practice when using convex appliances.

Method: A pilot study was conducted in the form of a questionnaire. The questionnaire comprised of numerous questions regarding current SCN practice pertaining to the use of convex appliances. It was sent to 24 stoma care nurses, within both Primary and Acute Care settings in the UK.

Results:  54% response rate. The pilot study highlighted some interesting variations in current stoma care nursing practice. Reassuringly, 100% of respondents stated that convex appliance usage was primarily governed by the depth/degree of retraction. However all those asked were practicing stoma care nurses, so perhaps the result may have been different if non-specialist nurses had been asked?  85% SCN would opt for soft convex post-operatively initially if patients were experiencing problems with leaks. 77% prefer to use a cut to fit convex appliance as “not all stomas are round, sometimes need to adapt size and shape continually!

Conclusion: This small pilot study highlighted some interesting and thought-provoking issues when reviewing SCN usage of convex appliances. The study should be replicated on a much larger scale, to facilitate the development of best practice guidelines for the use of convex products.