The best site for a stoma must be defined preoperatively. This permits easy application of appliances.
Patients are assessed in their day clothing in the lying, sitting and standing positions. Any other functional positions are also considered, e.g. sitting at a work desk.
The patient must be able to see the proposed stoma site. The following sites are avoided to help prevent leakage:
- sites of proposed incisions
- bony prominences
- existing deep scars
- groin creases
- deep skin folds
It is conventional to place an ileostomy in the right iliac fossa and a colostomy in the left iliac fossa.
Specific problems are encountered with wheelchair-bound patients, amputees who need to wear straps to secure a prosthesis, and obese patients. Allergic patients may need to be patch tested in order to find an adhesive they are not reactive to.
Last reviewed 09/2021