Abdominal binders - colostomy site herniation - Responses

Posted By: Christian Meier on July 25, 2011

Thanks for all the responses, I think we will try adding some pressure with
some zote around the ostomy site since she already has several binders and
this seems like it may be the easiest solution for everyone. If that doesn't
work than we may try doing a custom molded rigid anterior panel. Thanks
again everyone.

-Chris Meier
Orthotic Resident
Dynamics O&P
LA, California

Original question:

Hi List,

I have been asked to provide suggestions on an abdominal binder or corset
for a patient with chronic herniations around the ostomy site. The patient
currently has an elastic ab binder that is made to work with colostomy bags,
but it is not providing enough compression to control the herniation about
the ostomy site. Any suggestions would be greatly appreciated. Thanks. I
will post replies.

Chris Meier

Orthotic/Prosthetic Resident
Dynamics O&P
LA, California

Responses:

One thing we've done though is stuck with that same rib binder, but added
some 3/16 or 1/4 inch zote trimmed & skived down over the herniation site
for more directed pressure.

Good luck! Universal precautions!!!
Lindsay
Sent from my Verizon Wireless BlackBerry

custom molded, anterior opening, soft type LSO from Boston Brace and had
great results. I took a hand cast of her torso using fiberglass and clearly
marked the colostomy bag site. I even sent the cast off with a sample
"clean/new" bag to make sure it could pass through the hole. The patient
said it was the most comfortable brace she has had to date.

Alexander L. Lyons, C.P.O.
Lyons Prosthetics & Orthotics, Inc.
123 Waccamaw Medical Park Drive
Conway, SC 29526
843-347-5800
www.lyonsoandp.com

I Use NU- HOPE labs- I would call :
Christine Ines
Nu-Hope Laboratories, Inc.
12640 Branford Street
Pacoima CA 91331
Toll Free (800) 899-5017 Ext#108
Fax (818) 899-2079

Maybe you have maybe you have not?
I find them to be very helpful when you call.
They have options.

Hugh G Panton II CPO

What i have done in the past is place a sheet thick leather .kept it in
place with a piece of velcro . This is a firm solution and wil not ad to
much volume.
Greets stan

We have ridiculous success with custom molded, to cast, abdominal panel,
made out of 1/8 semirigid foam lined with Aliplast. Opening for colostomy
bag executed during fitting. We attach this to a modified Cybertech brace.
WORKS SUPERB. Attached is pic of one of the patients we had it made for.
Bandage is covering one large hernia. No, you do not have to post this.

I. Lesko, LPO

Trial fit the Patient with a canvass type L.S. support and provide an
opening for the Ostemy site.


Joe Perry CPO

I've just finished with a patient with the same problem. We put him
in an LSO with a solid anterior panel. We cut a hole for the ostomy
bag through the panel and sealed the edges of the hole to prevent
leaks into the pocket. The size and location of the hole is critical.
It's not a perfect system but does work better than the binder. The
patient is frustrated with all the excess straps over the binder but
still likes the better support provided by the solid anterior panel.

Harold Anderson, CO

Have made an opening in the garment that would be of correct size(alittle
trial and error may be needed for deterimining this size)and then sewed two
pieces of surgical elastic over this opening with the bound edges of this
elastic running the length of the opening you created. This will allow
the ostomy bag to be placed in the slit of the elastic and yet provide
compression to the area.I have not had any problems with this procedure and
have tried other methods of dealing with ostomies that proved to be
unsatisfactory.Good Luck

I have been using Trulife's garments and placing them over the patient's
ostomy device, marking the opening size, and then cutting an opening and
sewing binding around the perimeter. Make the whole/opening large enough
for them to pull the bag thru, but not so large as to allow the hernia to
grow. I've also made a couple of HDPE panels with openings that my patient
can slip into the garment to act as a buttress, one firm and one more
flexible as one of my colostomy patients with a large hernia is a
gastroenterologist himself that still plays tennis 3x a week and is quite
vigorous for his 72 years! I recently had a patient in an urostomy device
and she is thrilled to have the back support in addition to control of her
herniating ostomy site. I am out of my office, but if you email me back
Monday I'll send you some pictures. The LSO's from Trulife are Century
XXIII or something like that, pale yellow in color and canvas material that
works well. I give my patients 2 garments as they need to have one to wear
and one to wash and I bill their insurances after getting PA from a case
manager to cover/allow the extra garment not normally paid for. Haven't
done any on Medicare, but have another patient with a Medicare HMO that was
willing to put me in touch with his insurance company and they were quite
understanding. I usually take a picture of their device and that usually
gets me what I need. Good luck!

We typically find a good, supportive elastic corset, then cut a circular
hole large enough for the ostomy site. Then you'll want to sew bias-tape
(from any fabric store) around the cut edge to prevent fraying of the
material.

Kristin Faircloth, CO

You might try the Kerr-Lagen Obesity support (Truform # 414). Because it is
non-elastic it can be pulled as tight as necessary but wonít give when the
patient coughs or sneezes. I have used it several times for ventral hernias
with reasonable success.****

** **

Harry Phillips, CPO****

Triangle Orthopaedic Associates, P.A.****

Orthotics and Prosthetics Department****

120 William Penn Plaza****

Durham, NC 27704****

(919) 281-1814****

Fax: (919) 281-1877****

[E-mail Address Removed]

The message above was posted to OANDP-L, the e-mail discussion list for orthotics and prosthetics.