The Journal of Stomal Therapy Australia - Australian Association of ...

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Initial Two-Piece Appliance Management System Skin barriers were used to protect the peristomal skin. Stomahesive powder was applied to the friable sinus opening to control the bleeding. Seals were applied to create a convexity effect in order to provide more security (Figure 4). The larger base plate provided adhesion over a greater surface area and the rim on the base plate provided a firm base to prevent the folding in of abdominal creases. In addition, using a cut-to-fit appliance accommodated the changes in sinus opening sizes (Figure 5). The aperture of the base plate was cut larger to provide a more uniformed surface coverage. The base plate only required changing twice weekly and the client was able to manage bag changes as required (Figure 6). As the sinus continued to contract the appliance system required adjustments. Leakage became problematic resulting in extensive erythema, which extended outward from the stoma opening. Furthermore, there were friable superficial ulcerations throughout this area. The contraction of the sinus resulted in further creases and indentations, particularly evident at the lateral corners of the sinus opening. Figure 7 Figure 8 surface area. The one-piece appliance was more flexible and provided better adhesion along the folds and creases (Figure 8). The appliance aperture was again cut larger to provide a more uniform coverage onto the skin surface. Although the appliance required second daily changes, the ease of application enabled the client to self-manage appliance changes. Collaborative Management A collaborative approach with the client, stomal therapy nurses both within the acute and domiciliary setting, GP, colorectal consultant and other members of the multidisciplinary team is important when managing a client with a complex stoma. This ensures that ideas for management options are shared, agreed management goals are achieved and changes in the client’s condition are communicated. Figure 5 Figure 6 Outcome The client’s peristomal skin recovered and he was able to selfmanage appliance changes with no further leakages. He had the reversal of his colostomy and although he required wound management post-operatively for twelve weeks for a large wound dehiscence, he has now completely healed and has resumed his usual life routines. One-Piece Appliance Management System Peristomal skin was protected using barrier film. A combination of Stomahesive powder, Stomahesive paste and cement bond was applied to the denuded peristomal skin to create a crust for appliance adhesion and to encourage epithelialisation of the skin. Stomahesive paste was used to fill creases and indentations to the lateral sinus Opening Seals were applied to create a convexity effect in order to provide more security (Figure 7). A one-piece Stomadress appliance was used as the larger base provided adhesion over a greater STOMA APPLIANCE SCHEME UPDATED SCHEDULES Available from the Department of Health website www.health.gov.au/stoma If the page does not show immediately, use the www.health.gov.au search system and you will find it by typing in: stoma appliance scheme JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3)
S c i e n c e • S o l u t i o n s • S a v i n g s K E N DA L L W O U N D C A R E P RO D U C T S * Powerful protection against nosocomial infection Anti-Microbial Dressings Prevention is better than Treatment With the antimicrobial component PHMB (Polyhexamethylene Biguanide) AMD * dressings resist bacterial colonisation of Gram-positive, Gram-negative and Yeast/Fungi microorganisms. AMD * products help to provide valuable insurance against the substantial costs associated with nosocomial infections. Unique & effective •Low cost infection control •Broad spectrum effectiveness •Works within and through the dressing •No known resistance •Gentle to healthy cells Tyco Healthcare - Australia 166 Epping Road, Lane Cove NSW 2066 Customer Service Ph: 1800 252 467 * Trademarks of Tyco Healthcare Group LP. Customer Service Fax: (02) 9418 7137 WC 044-02-06
Page 1 and 2: The Journal of Stomal Therapy Austr
Page 3 and 4: President’s report It’s our AAS
Page 5: Challenges of managing a retracted
Page 9 and 10: Survey research considered the rate
Page 11 and 12: Only 11.7% of clients were discharg
Page 13 and 14: The Elinor Kyte Research Grant Aust
Page 16 and 17: Risk management in stomal therapy p
Page 18 and 19: You say We asked STNs from Australi
Page 20 and 21: poor construction of the stoma pati
Page 22 and 23: Back in Control, with confidence. F
Page 24 and 25: Colorectal Surgical Society of Aust
Page 26 and 27: Beneath the waves Grant McLaren •
Page 28 and 29: one’s back in the bottom of the v
Page 30 and 31: YOU Inc President’s report March
Page 32 and 33: State reports Australian Capital Te
Page 34 and 35: Sue Delanty remains on the Educatio
Page 36: News updates A new super clinic has

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