Stoma siting is often regarded as the most important aspect of pre-operative stoma preparation ( Readding, 2003 ; Rutledge et al, 2003 ), however, time spent with the patient discussing the finer points of surgery and what can be expected throughout the process is also crucial. Having the opportunity to meet with individual patients prior to surgery allows for the advanced exchange of information and the ability to discuss stoma formation from conception to ultimate patient management in its entirety. This arms the patient with the relevant information before surgery ever takes place, and prepares him or her for the time ahead. This article looks at the steps taken by the stoma care nurse (SCN) in preparing the patient for such surgery.

Advanced silicone technology has transformed the treatment of wounds and peri-wound skin. Recently, there has been interest in the use of silicone-based products in stoma care. Peristomal skin issues are a common problem, and can have a negative impact on the patient's quality of life, so helping the ostomate maintain good skin health is crucial. The author, a stoma care nurse, regularly sees 3-4 patients each week in her stoma care clinic with damaged or broken peristomal skin. This article explores the 'Trio' range of silicone-based accessories, discussing how these products compare with the traditional hydrocolloid, how they are applied and used. A series of case studies illustrates the circumstances in which these products may be applied.

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This article provides an overview of convex stoma products, and outlines the consequences of the inappropriate use of such products. Four separate problems are identified and examined: mucocutaneous separation; friction and granulomas; accumulative peristomal skin pressure; and capillary trauma/skin discolouration. It is noted that not every conceivable problem has been included, for example, peristomal ulceration. Summaries of each specified problem are shown against photographic evidence, along with advice about the use and management of convex products.

The importance of siting a patient prior to stoma surgery (be it actual or potential) cannot be under estimated. Preparing the patient and significant others (i.e. family members, carers, and relatives) is hugely important to the outcome and optimises a good postoperative recovery. Assessing the patient, his/her abdomen, physical appearance (i.e. manual dexterity, vision), and gait (i.e. posture, spinal curves) all facilitate in highlighting potential positioning problems. This in turn allows the stoma care nurse to optimise the ideal stoma location—one that is accessible and, where possible, visible to the patient. It is important to remember that each patient is unique, and thus, the process of siting can vary from one to another; nurses should allow at least 1 hour for the completion of the task. The aim of this article is to take the nurse/nurse specialist through the act of siting in a comprehensive manner. It is hoped that this article outlines the need for preoperative assessment and, indeed, the marking of the abdomen.