Areas to avoid in siting stomas

• The waistline

• Previous scar lines

• Fat folds and bulges

• The umbilicus

• Current fistula and drain sites

• Under pendulous breasts

• The primary incision site

• Any areas that have skin problems such as psoriasis

• Areas crossed by straps for artificial limbs or other surgical appliances

• Areas where, if there was weight loss or gain, the stoma would be difficult to manage.

At the end of the siting of the stoma, it should be recorded in the patient notes that the stoma site has been marked with the consent of the patient in an agreed area and the site on the body recorded either by diagram or by written word. In some hospitals stoma care nurses use digital cameras and place the photograph in the patient's medical notes. By recording this information in the medical notes, the nurse is covered if there should be any query or litigation about the site of the stoma.

Figure 8.1 Ostomy: side view. (Courtesy of Dansac Ltd.)

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