19 February 2018

NEW CLINICAL GUIDELINES FOR PARASTOMAL HERNIA PREVENTION AND MANAGEMENT WILL SECURE SYSTEMATIC APPROACH

The British Association of Stoma Care Nurses (ASCN) has recently settled evidence based clinical guidelines for parastomal hernia prevention and management (The British Journal of Nursing, December 2017).

The background for issuing these guidelines is that due to continuous changes in age demographics, an increased number of experienced and competent stoma care nurses is retiring and taking with them extensive expertise and specialist knowledge about stoma care and hernia prevention and management. In order to secure expertise and knowledge at a high level and to further improve patient experience and patient outcome, a systematic approach to stoma and hernia prevention and management is needed, resulting in equality and consistency in practice and establishing a central resource of knowledge. This is ensured in the guidelines. In the following, we present abstracts of these guidelines and link them to our recommendations for use of hernia support garments.

1. ASCN GUIDELINES FOR HERNIA PREVENTION

Regarding parastomal hernia prevention, the guidelines state that “patients with a stoma are assessed by a Stoma Care Nurse (SCN) and an individualized prevention of parastomal hernia plan is formulated”.

The Stoma Care Nurse not only explains the stoma patient what a parastomal hernia is and what consequences it has, but also makes an individual assessment to identify disposing factors of parastomal hernia. Factors such as stoma type, obesity, lifting, muscle weakness, multiple abdominal surgeries, straining, coughing, occupation, general lifestyle etc. should be taken into consideration. In conjunction with a clinical assessment of individuals who possess high risk factors, a higher level of support garments should be considered as per local policy.

All patients are advised about core muscle exercises and the purchasing of lightweight high-waisted support underwear, potentially prescribed if required.

In the guidelines it is described that the underwear is readily available from specialist ostomy manufacturers and high street stores, department stores, and even sports shops – especially for gentlemen. Underwear available on prescription should be considered with prescription costs and local policy in mind when providing advice.

The information given should be reinforced at regular intervals, e.g. at 1, 3, 6 months as well as annually.

Read full article in BJN magazine of 14 December 2017

2. ASCN GUIDELINES FOR HERNIA MANAGEMENT

In the area of parastomal hernia management, the guidelines state that “patients with a parastomal hernia are assessed by a Stoma Care Nurse (SCN) and an individualized treatment/management plan is formulated”.

Apart from the identification of predisposing factors for parastomal hernia development in the patient, the patient is examined in a lying and standing position to determine and document hernia size, severity as well as skin integrity. Quality of life is registered in a questionnaire.

Regarding the need for support garments, stoma care nurses are encouraged to use their clinical expertise to determine the level of support underwear/garment required for the parastomal hernia, advising of both high street store and prescription support underwear and garments.

(Read full article in BJN magazine of 14 December 2017)

The ASCN GUIDELINES IN RELATION TO TYTEX SUPPORT GARMENTS

At Tytex, we fully support the guidelines, as they obviously recommend the use of hernia support garments. However, we always recommend users to buy support garments from professional ostomy and hernia garment providers, as these garments are specifically designed and manufactured to meet the users’ needs and address their concerns.

People with hernia are not the target group of high street stores, department stores and sports shops and hence the products these stores can provide lack the professional and medical as well as the clinical performance towards optimal design for hernia care.

We also always recommend maximum support garments as first choice for hernia management and prevention, however, the level of compression must always be based on an individual assessment. Our support garments are designed in close cooperation with stoma care nurses and are all tested on people with hernia. This ensures that the medical as well as the comfortable performance is in place, which is key for a high quality support garment.