Stoma siting: what the community nurse needs to know

Stoma siting is often regarded as the most important part of preoperative preparation. Marking the abdominal skin at the proposed stoma site takes place after a period of assessment, discussion, observation, consideration and evaluation that will have begun on the first meeting between the patient and the nurse. The siting procedure is a joint decision made between the patient and the nurse about the most suitable place for their stoma. The position of the stoma should allow the patient to manage it independently and to resume their normal activities after recovery. The success of the stoma can depend on the site and its condition. The purpose of this article is to describe and discuss the siting process and how it benefits the patient. Community nurses should gain a greater understanding of the issues involved, as well as the considerations for both the nurse and the patient. This article is intended to help the community nurse feel more aware of the issues involved in siting, and feel more prepared to assist the patient to prepare for and begin their life with the stoma. The outcome and effects of a 'poorly' or 'less than ideally' sited stoma (e.g. formed during emergency surgery), and its care and management will also be discussed. Illustrations have been included to assist the reader through the process of siting.