Finding the right fit

Ms Kate Brereton1
1St John Of God Murdoch , West Leederville, Australia

A demonstration of pre-surgery assessment of a prospective colostomy patient using expert clinical skills to determine the appropriate stoma pouch selection.

Mrs S, a 64-year-old woman, was to have an elective abdominoperineal resection.

On meeting Mrs S a severe tremor in her hands, and altered gait was obvious. Mrs S stated the reason for her foot drop and upcoming colostomy surgery was  complications of spinal surgery that had led to her becoming incontinent of urine and faeces. Her tremor was due to Parkinson’s disease. She presented as eager for information about colostomy as she was obviously distressed about the faecal incontinence and the impact this had on her life and particularly on her husband. Mrs S looked forward to having a stoma to control her faecal incontinence and was motivated to be independent and self-caring post-surgery. She was keenly interested in the education provided and welcomed to opportunity to view stoma appliances and “try them out”.

The patient and the stomal therapist seized the opportunity for pre-surgery assessment and evaluation of the patient’s physical capabilities and limitations. Mrs S was given a variety of appliances with explanations about the key features each product. The STN assessed her ability to utilise these stoma appliances while she manipulated them, to predict which stoma appliance could work best for her.

Assessment post-operatively revealed a soft abdomen with an imperfect stoma, plus her marked tremor, which highlighted the importance of identifying essential features of the stoma appliance in order for the patient to achieve independence with stoma management.


As a stomal therapist for 7 years I have a passion and an interest in the education an appropriate counselling for my stoma patients. I work as a stomal therapist at a large private hospital in Perth Western Australia that provided services to both metropolitan and rural clients.