Stool Management: Advanced Technology Performance with a Safe Solution for Fecal Containment in Incontinent Patient

Abstract

In an acute care setting the incidence of fecal incontinence (FI) can occur from 17% to 33% according to the Wound Ostomy Continence Nursing (WOCN) Society’s Continence Committee. A new stool management system has been designed to manage FI in non-ambulatory patients and has proven to be efficacious in wound management and prevention, effective in infection control, provide safer patient outcomes, and enhance ease of nursing. “Intended for use primarily in acute care settings, intra-anal management systems are developed for insertion into the rectal vault for diversion of liquid stool away from the skin in immobile patients” (WOCN Society’s Continence Committee, 2013, p. 12). This device has a wider patient eligibility and potentially allows three times more FI patients to be safely managed. It has safer intra-rectal pressures compared to indwelling balloon catheters. This in-vitro study, along with pilot clinical findings, suggests that advanced technology minimizes the pressure exerted on the rectal wall. Safer insertion/withdrawal forces with significantly less force upon the anorectal mucosa compared to cuff-based catheters during insertion, withdrawal, and accidental expulsion. The intuitive device applicator and innovative self-expanding stool diverter of the devices may help reduce the risk of anorectal injury during insertion, withdrawal, or accidental device expulsions. The device design comparatively decreases undesired leakage outcomes by maintaining a larger lumen during both resting and peristaltic states, and by completely avoiding the need for balloon cuff-based anchoring. These in-vitro observations are in line with observations in clinical studies conducted at tertiary care centers. A major concern with the use of intra-anal management systems is the potential harm to the rectal mucosa and the advanced technology with this device greatly reduces that risk. A sample size of 20 patients were studied and according to Consure Medical (2016) “pre and post-sigmoidoscopy was performed on all enrolled patients and all maintained the health of their rectal mucosa” (p.5).

References

Consure Medical. (2016). Fecal management highlights. San Francisco, CA
Mayo Clinic. (2016). Fecal incontinence. Retrieved from http://www.mayoclinic.org/diseases-conditions/fecal-incontinence/home/ov...
Wound Ostomy Continence Nursing Society’s Continence Committee. (2013). A quick reference guide for managing fecal incontinence. Mount Laurel, NJ