Ostomy Bag and Betel Leaf in Pediatric Stoma Care

Background: Construction of a stoma is a common procedure in pediatric surgical practice. For care of these stomas, commercially available devices such as Ostomy bag, either disposable or of longer duration are usually used. These are expensive, particularly in countries like Bangladesh, and proper-sized ones are not always available. We have found an alternative for stoma care, betel leaf, which is suitable for Bangladeshis. Objective: The main objective of this study was to compare between Ostomy bag and betel leaf in Pediatric stoma care and also comparison of skin excoriation between Ostomy bag and betel leaf using in pediatric stoma care & comparison of cost and care givers satisfaction of the study groups. Materials and Methods: A total of 60 patients having various types of stoma within the age of 12 years were included in the study and randomly assigned to 2 groups – group 1 with Ostomy bag (30 patients) and group 2 with Betel leaf (30 patients). After construction of stoma, at first zinc oxide paste was applied on the Peristomal skin. A betel leaf with shiny, smooth surface outwards & rough surface inwards was put over the stoma with a hole made in the center according to the size of stoma. Another intact leaf covers the stomal opening. When bowel movement occurs, the overlying intact leaf was removed & the faecal matter was washed away from both. The leaves were reused after cleaning. Use of commercially available Ostomy bag (e.g., Convatec ostomy bag) with Adhesive paste (Stomahesive) will be applied on the Peristomal skin. Results: Out of 60 pediatric patients, 20 had pelvic colostomy, 19 had transverse colostomy and 21 had ileostomy. Of 60 patients under stoma care Mild excoriation had seen 21.7% cases of ostomy bag group and 13.3% cases of betel leaf group. Only 5% cases of ostomy bag group had moderate excoriation (P value was 0.116 which was not significant).Out of 40% excoriation, 30% occurred in ileostomy (p value <0.0001, hence significant). .....