According to the WOCN Society, in collaboration with the American Society of Colon and Rectal Surgeons, preoperative stoma site selection and ostomy education should be performed for all patients who are undergoing surgery that may involve the creation of a stoma. This statement is supported by numerous evidence-based studies that show fewer postoperative complications when a stoma site is selected pre-operatively.
The appointment
A referral to the St. Charles outpatient Wound & Ostomy clinics can be obtained from your primary care physician or the surgeon who will be performing your procedure. The outpatient setting is ideal for this preoperative visit. The hour-long visit provides ample time, with no interruptions, for stoma site marking and education regarding the planned procedure and postoperative expectations. The ostomy nurse can also discuss ostomy resources, including supplies and ostomy support group information.
Issues that are explored during the preoperative stoma site marking visit include:
- Surgical considerations and diagnosis
- Physical considerations and limitations, including a protruding abdomen, skin folds, and the presence of scars or other stomas
- Patient considerations and limitations, including vision, manual dexterity, age, occupation, and clothing preferences
- Positioning considerations and limitations, which may include whether a patient uses a wheelchair or has postural issues such as contractures or scoliosis
Ideally, the stoma site should be placed in an area you can easily see to facilitate self-care. The stoma site selection is completed after the ostomy nurse visualizes your abdomen while you are lying down, sitting, standing, and bending forward.
Preoperative stoma site marking, along with pre– and postoperative education, has been shown to reduce complications, promote self-care, and improve an ostomate’s quality of life.
