An assessment of surgeons' abilites to site colostomies accurately

Clinical Practice Guidelines for Ostomy Surgery

“…140,141 in addition, ostomy site selection has been shown to vary in quality among nonspecialist surgeons and specialist surgeons, with the standard being site selection by an ostomy nurse specialist. 142 for all of these reasons, the american society of Colon and Rectal surgeons believes that the optimal care for patients undergoing ostomy surgery includes preoperative, perioperative, and postoperative care by an ostomy nurse specialist, such as a nurse certified by the Wound, ostomy, and Continence nurses society (WoCn) Certification Board. 143 however, not all clinical circumstances allow for this optimal care, particularly in remote areas and in the setting of emergency operations.…”

“…macdonald and colleagues studied the ability of surgeons and surgical trainees to choose an appropriate ostomy site, and found that surgeons chose sites different from the ostomy nurse (the standard), with most "badly sited" ostomies being placed too low on the abdominal wall. 142 Colorectal surgeons were found to choose sites more concordant to the ostomy nurse specialists. a survey of surgical trainees showed that their training in ostomy site selection was haphazard and infrequently provided by the ostomy nurse specialist.…”

“…a survey of surgical trainees showed that their training in ostomy site selection was haphazard and infrequently provided by the ostomy nurse specialist. 142 in 2007, the american society of Colon and Rectal surgeons and WoCn published a Joint Position statement of the value of preoperative stoma marking for patients undergoing fecal ostomy surgery (available at the following Web site: http://www.fascrs.org/physicians/ position_statements/stoma_siting/). 154 surgeons who will be called on to choose ostomy sites should familiarize themselves with the principles of proper ostomy site selection.…”

Avoidance and Management of Stomal Complications

“…Poorly sited stomas often are located too low on the abdominal wall. 2,28 The stoma should be brought through the rectus abdominis muscle. Although there are instances in which partial transection of the muscle is needed, every effort should be made to use a muscle-splitting technique.…”

Methods for siting emergency stomas in the absence of a stoma therapist

“…3 Stomas may have to be sited by trainees, who are often unaware of the principles behind stoma siting. 4 There are many papers published on this topic but nearly all are in the form of case series analysed retrospectively; very few randomised controlled trials have evaluated different methods of siting.…”