New stoma care pathway launched

Year-long review leads to action on unwarranted variation in parastomal hernia care

Tuesday 18th June 2019

A report and action plan have been published to ensure patients across NHS Scotland receive consistent advice regarding parastomal hernia prevention and management.

Reviewed and approved by the chief pharmaceutical and nursing officers, the new approach is to be rolled out across Scotland with support from the Scottish deputy nurse director group.

A stoma is an opening made on the surface of the abdomen in order to divert the colon or ileum through the abdominal wall, allowing the flow of faeces or urine into a stoma bag worn on the stomach.

When a stoma is brought out through the wall of the abdomen it must pass through a layer of muscles, making a potential area of weakness, where a parastomal hernia could potentially develop.

In some cases the muscles come away from the edges of the stoma creating gap and hence a weakness for a parastomal hernia to form where there is no muscle.

Support garments sold to prevent and manage parastomal hernia represent a significant proportion of healthcare prescribing expenditure despite ‘a limited evidence base to support clinical use’, according to the ostomy support garment short life working group.

The group found levels of inappropriate prescribing and waste associated with unwarranted variation throughout Scotland – something the new action plan will seek to address with a ‘once for Scotland’ approach.