By Arthur Clarke, RNET, Gettysburg
Throughout the lifetime of a person with a stoma, the ostomate will probably have to change the type of stoma equipment several times. One reason for a change is that the shape of an abdomen changes with time, resulting in the need for equipment with different characteristics. I would like to discuss the reasons requiring a different appliance and the characteristics of some common appliances. To begin with, the surgeon allowed only so much moveable bowel in the construction of your stoma. Once that piece of bowel was pulled through your abdominal wall, it was tacked down on the inside of the abdominal wall and on the outside of the skin. That length will remain constant throughout your life; therefore, if the wall of your abdomen thickens (say with fatty tissue), and the length of the bowel used for your stoma is not affected. One result of the limited length of bowel with increased abdominal wall thickness, is that when you sit or stand, the changed position allows the abdominal wall to shift forward and down, and the stoma segment prevents the peristomal skin from shifting as much as the rest of the abdomen. The limited movement results in a "skin swell" around the stoma when you sit or stand. Skin adjacent to the stoma becomes quite mobile being pulled down, then flattened by your changing positions. Any skin barriers can hold up under the strain. I have found that by using an appliance with a firm, convex surface which "pushes" the skin back and holds it stable, relative to the stoma, it works much better than the highly flexible pouches.
Via: Metro MD.
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