title: Description of a Simple Method of Stoma Protection During Prone Positioning.
abstract: Surgeries conducted with the patient in the prone position are frequent and can be lengthy. Abdominal stomas and su- prapubic catheters require protection for the complete duration of the procedure to avoid complications such as stomal ischemia, bleeding, or mucocutaneous separation. Standard protection strategies such as pillows and wedges can eas- ily fail. In the course of managing several patients who had sustained ostomy complications following surgery in a prone position, a simple method of stoma protection was devised. Instead of discarding the foam headrest typically used dur- ing induction by anesthesia staff, this device is placed with its central recess over the stoma and secured to the patient's abdominal wall with gentle tape just before turning the patient into a prone position. This method, used in more than 80 patients, has been found to effectively relieve pressure, and no complications have been observed. The foam shape also enables unobstructed drainage of fluids, facilitating collection and preventing leakage and contamination of the surgical field. Because the device is widely used by anesthesia, it is readily available and does not add any extra cost.
authors.affiliation: Department of Hand, Plastic, and Recontructive Surgery, Burn Center, BG Trauma Center, Ludwig- shafen, University of Heidelberg, Heidelberg, Germany.
authors.forename: Gina A
authors.initials: GA
authors.lastname: Mackert
authors.affiliation: Department of Surgery, Division of Plastic Surgery, University of California San Diego Medical Center, San Diego, CA.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Reid
authors.affiliation: Department of Surgery, Division of Plastic Surgery, University of California San Diego Medical Center, San Diego, CA.
authors.forename: Marek K
authors.initials: MK
authors.lastname: Dobke
authors.affiliation: Department of Surgery, Division of Plastic Surgery, University of California San Diego Medical Center, San Diego, CA.
authors.forename: Mayer
authors.initials: M
authors.lastname: Tenenhaus
mesh_terms: D006801:Humans; D055805:Moving and Lifting Patients / Q000009:adverse effects*; D011183:Postoperative Complications / Q000517:prevention & control; D016684:Prone Position; D054047:Surgical Stomas / Q000009:adverse effects*