A Simple Gas-Venting Device for Ileostomy and Colostomy Appliances A. 1,V. MARTIN MARINO, JR., M.D.

['tom the Department of Colon and Rectal Surgery and the Departnzent of Surgery, The Broohlyn Hospital

Broohi)'n, New York

THIS report is intended to describe a simple, inexpensive device, originated by one of my patients. Four months previ- ously he had undergone a total colectomy and proctectomy with permanent ileostomy for ulcerative colitis. The contrivance is easy to clean, easy to operate, may be trans- ferred from one appliance to another, and can be used on any type of rubber appli- ance. The component parts are readily available and it requires a minimum of skill to assemble them.

Material Required (Fig. 1): Two washers, approximately the size and thickness of a (lime.

One round head (%2) screw, ~ inch long.

One quick fastener (%2) nut. This type of nut is usually used for electrical testing equipment or on model train transformers for the purpose of tightening terminal con- nections.

Assembling the Device: If necessary, drill

A

B

the center hole of both washers so that the screw will fit into them loosely. Insert the head of the screw into the hole in the center of one washer and braze or weld the head of the screw to the washer.

Fitting the Device to the Elastic Appli- ance: Two holes, with a circumference slightly larger than the screw, are punched through both the front and the back walls of the elastic bag. They should be placed approximately one half to three fourths of an inch below the upper margin of the bag. The screw with the attached washer is inserted through the holes with the head of the screw pointing toward the patient's body (Fig. 2). The other washer is then placed over the screw and is held in place by screwing the nut against the washer (Fig. 3, 4).

Comment

When tile ileostomy appliance is in use the nut is kept firmly tightened, thereby

C Fro. i. The necessary parts. A, Screw brazed to

washer. B, Washers. C, Quick fastener nut.

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Fro. 2. One washer attached to the screw head near the upper region of the elastic bag.

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effectively prevent ing escape of gas or fecal material (Fig. 5). When it is desirable to release accumulated gas, the nut can be easily loosened and, by applying pressure on the elastic appliance, the ent rapped gas can be evacuated. T h e nut is then tight- ened and it remains in the tightened posi- tion until evacuation of gas has to be repeated. T h e pat ient can do all of this without having to seek the privacy of a toilet or a bathroom.

It should also be noted that an opening can be fashioned in undershorts so that the rubber port ion of the appliance comes in contact with the skin only where the ['ace plate is secured by adhesive paste (Fig. 6). This would be helpful to ileos- tomy patients who are allergic to rubber or whose skin becomes irri tated by contact with the appliance.

A__..

B

C

FiG. 3. D iag rammat i c representa t ion of the gas- vent ing device installed. A, T h e ven t ing valve. B, Open ing for in tes t inal s toma. C, i leostomy or colostomy bag.

Fw,. 4. T h e device has been removed and is placed so that its appearance when assembled can be observed. T h e hole in the front wall near the upper marg in of the elastic bag can be seen. T h e r e is a corresponding hole in the hack w a l l

Fro. 5. T h e device instal led on tile appl iance.

Fie, 6. T h e i leostomy appl iance in place wi th the gas-vent ing device in posit ion, Note the open- ing in the pa t ien t ' s umlerwear , m in imiz ing contact of skin and rubber .