Ostomies and Stomal Care

Stomas are an integral part of our lives as surgeons. They can serve as the end of the intestinal tract, protect distal anastomoses, and relieve obstruction. A well-functioning stoma can allow a patient to live a productive life with minimal disruption. A problematic stoma may convert an otherwise successful operation into a persistent source of frustration for patient and surgeon alike. This issue of Clinics in Colon and Rectal Surgery is dedicated to intestinal stomas with contributions from experts in the field.

Drs. Marc Brand and Nadav Dujovny begin with a concise discussion of preoperative considerations necessary for the creation of normal ostomies. Dr. Peter Caltaldo continues with helpful tips for the construction of difficult stomas. Drs. Brian Kann and Tom Cataldo look at early stoma complications, and Dr. Malcolm Steel examines long-term stoma complications. This is followed by an in-depth look at the pathologic changes of the skin around the stoma by Ms. Donna Loehner, Ms. Merry Casey, and Dr. David Schoetz. Drs. Susan Seatter and Greg Beilman provide an excellent overview of the role of stomas in trauma. Drs. Kirsten Bass Wilkins and Kirk Ludwig summarize the indications and techniques for laparoscopic fecal diversion. Finally, Drs. James Wu and Victor Fazio review the current indications for continent ileostomy.