eP375 - Stoma Marking Site Prototype Device: An Interventional Prospective Pilot Study

Purpose/Background: Preoperative marking has been shown to decrease the likelihood of ostomy-related complications. The optimal site for a stoma may however vary from patient to patient. The objective of this prospective single-center pilot study was to compare the stoma location determined by the entero-stomal therapy (ET) nurse to the stoma location determined by a stoma marking site (SMS) prototype device.Methods/Interventions: Following institutional review board approval, a prospective study was conducted in a single center enrolling consecutive patients admitted for elective colorectal resections and able to provide informed consent. Various anthropometric variables, including abdominal girth (cm), body mass index (BMI) (kg/m2), gender, height (cm), torso length (cm), and weight (kg) were recorded. The anterior superior iliac spine (S), the pubic tubercle (P), and the umbilicus (U) were chosen as points of intersection (vertices) of an ostomy triangle, whose sides (SU, SP and UP) were measured using a SMS prototype device. SMS® is comprised of a calibrated angular scale with three semi-rigid branches made of transparent polymer material, which allows for placement of stoma markings on a patient's skin (Figures 1, 2). The stoma site marked by the ET nurse was correlated with the stoma site drawn by the SMS device, which is the incenter (I) of the triangle. The distance between umbilicus and incenter (UI) was measured by the SMS device. The endpoint of the study was the correlation between the stoma site determined by the ET nurse and by the SMS device. Statistical significance was set at p < 0.05.Results/Outcomes: During three months, 45 patients were prospectively included in this pilot study. There were 10 females and 35 males with a median age of 59 (interquartile range [IQR] 53–74) years, median abdominal girth of 95 cm, and median BMI of 27 (IQR: 23–29) kg/m2. Measurements obtained using the SMS device revealed an isosceles triangle with two congruent sides [median SU 18.1 (range 16–20) cm and median SP 19 (range 17–20) cm] and a base [median UP 15.6 (range 13–18) cm]. The average UI distance was 7.01 (range 6.3–7.5) cm. Positive correlations were found between BMI and abdominal girth (p < 0.001), and between SU and SP (p < 0.001), confirming that the ostomy triangle is isosceles. There was a statistically significant difference between the UI distance in patients with a BMI less than 30 kg/m2 as compared to that in patients with a BMI of 30 kg/m2 or higher (p=0.003).Conclusion/

Discussion: This prospective single-center pilot study has shown that the stoma marking site prototype device allows for the identification of the optimal location for a stoma in patients with a BMI less than 30 kg/m2 based on anthropometric variables known as the ostomy triangle.Figure 1. Stoma marking site prototype device (SMS®).Figure 2. Measurements with (SMS®) are taken over the abdominal skin, with anatomical references at the iliac spine (S), pubic tubercle (P), the umbilicus (U), and the incenter (I). Arrows (I, II, III) indicate branches of the device. UI distance “stoma marking site”.