A TECHNO-ECONOMIC NEWS MAGAZINE FOR MEDICAL PLASTICS AND PHARMACEUTICAL INDUSTRY
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Learning Zone

Colostomy & Colostomy Bags

 

Driven by an aging global population, increasing life expectancy, and rising incidence of incontinence diseases, the global market for ostomy and incontinence products market is forecast to reach US$15.7 billion by the year 2017. Rising incidence of incontinence, diseases such as bowel cancer, diseased colons, and other ailments are necessitating surgery, which in turn are generating demand for ostomy supplies. India is the second largest market for ostomy products in the world after China.

Colostomy is really a way to treat numerous disorders from the large intestine, which includes cancer, obstruction, inflammatory bowel disease, ruptured diverticulum, ischemia or traumatic injury. Although colorectal cancer is easily the most common indication for any permanent colostomy, no more than 10%-15% of patients with this particular diagnosis need a colostomy.

 

A colostomy is a surgical procedure in which a stoma is formed by drawing the healthy end of the large intestine or colon through anincision in the anterior abdominal wall and suturing it into place. This opening, in conjunction with the attached stoma appliance, provides an alternative channel for feces to leave the body. It may be reversible or irreversible depending on the circumstances.

 

During the natural function of the colon, waste is slowly pushed along the entire length as water is absorbed ending in the rectum and excreted through the anus. Due to the sphincter muscle at “the end of the line”, which acts as a valve, excretion is normally able to be controlled by the individual. Because the procedure takes this out of the equation, there is no longer any way to control the excretion of waste. There is no shut off valve, waste will simply exit the opening in the stoma without one being able to control it, so some sort of pouch to capture the fecal matter will be necessary.

 

Indications

 

There are many reasons for this procedure.

 

Some common reasons are:

 

• A section of the colon has been removed,
• A portion of the colon (or large intestine) has been operated upon and needs to be ‘rested’ until it is healed.

 

Options

 

Placement of the stoma on the abdomen can occur at any location along the colon, but the most common placement is on the lower left side near the sigmoid where a majority of colon cancers occur. Other locations include the ascending, transverse, and descending sections of the colon.[1] Colostomy surgery that is pre-planned usually has a higher rate of long-term success than surgery performed in an emergency situation.

 

Colostomies are not viewed positively due to the misconception that it is difficult to hide the pouch and the smell of faeces, or to keep the pouch securely attached. However, modern colostomy pouches are welldesigned, odour-proof, and allow stoma patients to continue normal activities. Latex-free tape is available for ensuring a secure attachment. People with colostomies must wear an ostomy pouching system to collect intestinal waste. Ordinarily the pouch must be emptied or changed a couple of times a day depending on the frequency of activity; in general the further from the anus (i.e., the further ‘up’ the intestinal tract) the ostomy is located the greater the output and more frequent the need to empty or change the pouch.

 

A good pouching system should be:

 

• Secure, with a good leak-proof seal that lasts for up to 3 days
• Odor-resistant
• Protective of the skin around the stoma
• Nearly invisible when covered with clothing
• Easy to put on and take off

 

Types of pouching systems

 

Pouches come in many styles and sizes, but they all do the same job – they collect stool drainage that comes out of the stoma. Some can be opened at the bottom for easy emptying. Others are closed and taken off when they are full. Still others allow the adhesive skin barrier, also called the face plate or flange, to stay on the body while the pouch may be taken off, washed out, and reused.

 

Pouches are made from odor-resistant materials and vary in cost. Pouches are either clear or opaque and come in different lengths.

 

There are 2 main types of systems available. Both kinds include an adhesive part that sticks to your skin (called a faceplate, flange, skin barrier, or wafer) and a  collection pouch.

 

• One-piece pouches are attached to the skin barrier

• Two-piece systems are made up of a skin barrier and a pouch that can be taken off and put back on the barrier.

 

The skin barrier or faceplate of the pouch may need a hole cut out for the stoma, or it may be sized and pre-cut. It is designed to protect the skin from the stoma output and to be as gentle to the skin as possible.

 

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