Alginate Molding and the Creation of Custom Pouching to Prevent Ileostomy Pouch Leaking and Improve Patient Quality of Life. A Case Study

Lead Presenter

Supporting Presenters

Bernice Ianacone BSN, RN

Presented At

Abstract

Many published studies address quality of life (QOL) among persons living with an ostomy. Pouch leakage is reported as having the most significant impact on the quality of life. Not only can it contribute to stress, but anxiety, depression, a lack of desire to participate in social activities and an inability or lack of willingness to return to normal activities; difficulty in maintaining a seal between the pouch and the skin also contributes to peristomal skin damage. An irregular stoma or irregular peristomal contours affect adherence of an ostomy pouch leading to leakage.

Ms. J is a thirty-six-year-old female with a history of multiple gunshot wounds to the abdomen as the result of domestic violence. Over four years, she endured numerous abdominal surgeries and had frequent hospitalizations. Most recently, she underwent enterocutaneous fistula removal and creation of an ileostomy. Short bowel syndrome and a high output ileostomy further complicated successful pouching.

Over a six week period, we tried multiple combinations of pouches and accessory products with wear times less than 24-48 hours. In consultation with Ms J, we decided to try alginate molding to have a custom pouch created. Within two weeks, we received two sample pouches with a high output tap. The first pouch lasted three days and required changing due to inadvertent tearing of the pouch by the patient. The patient achieved a seven day wear time with the second pouch and went on to achieve the same results when discharged home. In her words, “ the pouch gave me my life back” and allowed her to participate more in the lives of her young children. The alginate permitted molding for an accurate depiction of the irregular contours of the pouching surface not described in pictures alone.