The people that the ostomy industry forgot

An intestinal stoma is a profound alteration in body function that a patient must manage day to day over significant periods of time, often permanently. Although the creation of a stoma takes place in a tertiary care surgical context, long-term management is very often a primary care issue and most GPs and community-based nurses are familiar with patients with stomas. In developed countries, where the costs of stoma management supplies are often met wholly or in part by state or insurance-funded health systems, patients with stomas can choose from a range of disposable collection systems for stoma management that afford hygienic, discrete, and reliable collection. An entire subspecialty of nursing has grown that focuses on stoma care and guidelines have been developed for best practice in pre-operative and post-operative care, often including elements of counselling and stoma management education as well as medical care.1,2 But despite the health care and products that are available, the undoubted difficulty in adjusting to having a stoma results in considerable psychological stress in many, and the incidence of dermatitis and other complications around stomas is relatively high at between 15–43%.3–5 Living with a …