A parastomal hernia support belt is a specialized garment designed to manage a common complication that occurs after ostomy surgery. This hernia forms when the bowel protrudes through the weakened abdominal wall near the stoma, creating a noticeable bulge. The primary function of the support belt is to provide external compression and support, which helps to keep the hernia reduced and may prevent its enlargement over time. Wearing the belt correctly, especially with a stoma appliance already in place, requires specific knowledge and technique to ensure both support and safe function. Individuals should always consult with a Wound, Ostomy, and Continence (WOC) nurse before selecting and using a support belt.
Selecting the Appropriate Support Belt
A specialized parastomal hernia support belt differs from a standard abdominal binder, which offers generalized compression without accommodating the stoma appliance. Hernia belts are constructed to provide focused support around the stoma site, often featuring a stiffer material for containment. Accurate sizing is necessary for the belt to function effectively, requiring precise measurement around the abdomen, typically at the level of the stoma. The belt must fit snugly to provide adequate support but should never be so tight that it causes discomfort or restricts breathing.
Support belts are available in materials ranging from highly elastic fabrics to semi-rigid panels, depending on the required level of support and the user’s activity level. Users must select a belt with a pre-cut hole for the stoma appliance or one that covers the appliance entirely. Belts with a hole feature an aperture sized to fit around the base plate or flange, ensuring support is applied directly to the peristomal skin. The alternative, a belt without a hole, offers more even compression and may suit flexible pouching systems, though output flow must be monitored. The final choice depends on the stoma location, the pouching system in use, and personal comfort preference.
Step-by-Step Application Technique
Before applying the support belt, the ostomy appliance must be prepared; specifically, the pouch should be emptied completely to prevent unnecessary pressure or bulging under the belt. This preparation ensures that the support garment lies flat against the body. To achieve maximum hernia reduction before securing the belt, the user should lie down flat on their back. Lying down allows gravity to help the protruding tissue retract back into the abdominal cavity, enabling the belt to secure the area in a reduced state.
With the hernia reduced, the belt is brought around the abdomen and aligned for centering. If using a belt with a pre-cut hole, the opening must be perfectly centered over the stoma base plate, not the collection pouch, so the rigid support stabilizes the area around the stoma. For belts that cover the appliance, ensure the material is smoothed over the area without wrinkles or folds that could press unevenly on the appliance. The belt is then fastened, typically using a Velcro closure, and adjusted to the correct tension.
The proper tension is achieved when the belt is firm enough to provide support without causing excessive constriction. A practical check for appropriate tension is ensuring two fingers can comfortably slide underneath the secured belt. This level of tightness provides the necessary containment while allowing for natural abdominal movement and preventing pressure on the stoma or underlying tissue. Securing the belt with this measured tension ensures it supports the abdominal wall without hindering the function of the ostomy system.
Ensuring Stoma Function and Skin Integrity
After the support belt is applied, immediately check for any signs of compromised stoma function or circulation. The pressure from the belt must not restrict the flow of output into the pouch, which can lead to a complication called pancaking. Pancaking occurs when output pools around the stoma, potentially causing the adhesive seal to lift.
A visual check of the stoma confirms adequate circulation. The stoma should maintain a healthy pink or reddish color, indicating sufficient blood flow. Any change to a dusky, purple, or pale color is a warning sign that the belt may be too tight, requiring immediate loosening and consultation with a healthcare provider. The belt and its edges can also cause friction or pressure against the peristomal skin, especially around the adhesive wafer.
Upon removal, the skin around the stoma should be inspected for any new or increased redness, blistering, or signs of irritation. The belt material can generate heat and moisture, which contributes to skin breakdown and potential infection. Monitoring the skin daily for these signs helps prevent peristomal skin complications and reduce the appliance wear time.
Daily Wear and Safety Guidelines
Hernia support belts are intended for use during periods of increased abdominal strain, such as physical activity, exercise, or prolonged standing, rather than continuous wear. It is recommended that individuals remove the support belt before sleeping to give the abdominal area a break from constant compression.
To maintain hygiene and prevent skin irritation, the belt must be cleaned regularly according to the manufacturer’s instructions. Most belts can be gently hand-washed with mild soap and air-dried away from direct heat or sunlight. Regular cleaning is necessary because the belt absorbs sweat and can harbor bacteria, which may lead to skin issues.
Even with the belt in place, individuals must still adhere to general safety measures, particularly avoiding heavy lifting. Specific warning signs necessitate immediate medical attention, including severe, unexplained abdominal pain, persistent nausea or vomiting, or the inability to pass gas or stool, which could indicate a bowel obstruction. Any sudden or persistent change in the stoma’s color also requires prompt consultation with a physician or WOC nurse.