A stoma sited in theatre on a supine, anaesthetised patient often ends up in a skin crease, on the belt line or out of the patient's sight. Preoperative marking with the patient sitting, standing and bending, ideally by a stoma nurse, reduces leakage and skin problems and makes the appliance easier to manage.
Mark through the rectus muscle, away from scars, creases, the umbilicus and bony prominences, and where the patient can see it. Mark both sides if the type of stoma is uncertain.
- Arrange stoma-site marking before any elective resection where a stoma is possible
- Check the site with the patient sitting, standing and bending forward
- Place it through the rectus muscle, clear of creases, scars and the belt line
- Mark both sides when the choice between ileostomy and colostomy is not yet settled
Why it matters
A poorly sited stoma is a daily problem for the patient that no later revision fully solves.
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