Page 4 - OASC January 2021 Newsletter 2

4. Can you use StealthBelt with a 2-piece Hollister appliance with disposable bags without taking the whole belt off?
a. No, not really.
5. Do I need to wear a hernia belt after parastomal hernia repair?
a. Yes, it’s a newer guideline. Wear for at least a week after surgery.
b. Ostomates’ hernia rate is up to 70%. There are different types of hernias.
i. A reducible hernia is a hernia with a bulge that flattens out when you lie down or push against it gently.
ii. A non-reducible hernia cannot be popped back through the abdominal wall. It can pose risk of entrapping and strangling the protruding intestinal loop if/as the muscle around the hernia swells; can also obstruct output.
c. Physicians will not repair hernias unless they become obstructive. There are 3 different types of procedure:
i. Repair fascia
ii. Add mesh
iii. Move stoma site (most effective)
6. How long should you wear an appliance generally? a. depends on your own skin. As a rule, 5 days.
7. What questions should I ask surgeon re treating a 2nd hernia below a peristomal hernia?
a. There can be defects in the fascia leading to multiple hernias, dubbed Swiss Cheese abdomen.
If the hernia is not explosive, ask:
i. do they want to do a procedure to repair the hernia? Risk of a twist in bowel turning
into a block (Incarceration occurs when herniated tissue becomes trapped and cannot easily be moved back into place. An incarcerated hernia can lead to a bowel obstruction or strangulation. [Healthline.com])
8. What about stomal revision (e.g., when stoma is flat or retracted)?
a. It’s a problem you have to discuss with surgeon. Retraction happens because pieces that hold
your colon in place pull it back. In some cases, convexity can be done externally.
b. When stoma is fully retracted, it’s stenotic (narrowed down), meaning there is not enough
mesentery length to change the stoma format.
9. How to treat stinging rash around stoma?
a. Milk of magnesia,
b. Glaxal Base moisturizing cream for sensitive skin (over the counter product used for radiation
skin reaction), might affect adhesion of flange.
10. What other chronic conditions tend to coexist with ostomies, e.g., diabetes?
a. The cause-effect relationship between diabetes and colitis or Crohn’s is not clear. However,
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