Feacal Management Systems???

RN1989 · Jan 23, 2008

If you have the right brand and know how to use it - they are wonderful. I cannot remember the brand right now but there is one that uses a soft, pliable bag. You put the glue around the orifice and then the soft bag is put on. The bag made out of the soft latex glove material is the best. When put on correctly it can stay on throughout a lot of turning and moving in bed.

There are other brands that have "plastic" bags that do not stay on for anything. They are basically colostomy bags for the butt and come off the first time you turn the pt.

The trick to getting the bags to stay is to allow enough time for cleaning the peri-area and letting the glue sit. You really need to have help to spread the cheeks, clean well and pat dry. Then sit for a few minutes to ensure dryness. After that the glue is applied. You have to give the glue time to dry to a tacky finish. Then you put on the bag. The biggest problems I have seen nurses have is not allowing enough time for the drying. They want to get in and out. It really takes a good 20 minutes or so to do this whole thing to ensure a proper seal. One little leak and it makes a bigger mess and starts coming off.

If you do it right, these things are fabulous. And you quit having poop in the decub so you don't have to keep changing the dressing!

Do an online search for "fecal incontinence". You will likely get a few hits from companies that sell the products. You can print off info and pics for your presentation.

nrsang97, BSN, RN · Jan 23, 2008

check out flexi seal. They have a system ment for watery stool. Down side is it sits inside rectum and is inflated, and is also $900 per opened package. Works well with lots of turning. We also have the fecal pouch the previous poster mentioned. Works well also.

The flexi seal must be use for watery stool only. Sometimes pts go around the device and it needs to be inflated some more.

FNimuaeMae · Jan 23, 2008

At one of my jobs they have one called flexiseal... which are awesome for people with liquid stool. They are inserted rectally, have a water cuff you don't need to periodically release pressure from and can stay in for 29 days if I remember correctly. They do leak a little but anything is better than huge puddles of constant stool. They are pricey but we loved them when we got them.

Missy

queenjean · Jan 23, 2008

What I don't like about the flexiseal is that the tube is sosoft that if it isn't positioned just right, it kinks off. Or if the pt moves a little bit, it can flatten or kink it so the stool backs up and leaks. It would work better if the drain tube were firmer, maybe somewhere inbetween where it is now and a foley.

RN1989 · Jan 23, 2008

I have not checked into fecal incontinence systems in a while. Have they managed to get around problems of pressure and tissue necrosis with the internal fecal tubes? The last time I worked with one years ago we had policies on how long they could stay in, need for inflating/deflating balloon to relieve pressure, etc. due to side effects of the tube.

emmycRN · Jan 23, 2008

Don't remember the brand name, but my facility uses them. They are absolutely wonderful. The ones we use stay in place really well, but the best part is the bags are disposable so no handling poo at all with one of these in place. They are extremely helpful for the large, critically ill individual, with frequent loose BM's. Saves your back and their butt!

lorilou22RN · Jan 23, 2008

What I don't like about the flexiseal is that the tube is sosoft that if it isn't positioned just right, it kinks off. Or if the pt moves a little bit, it can flatten or kink it so the stool backs up and leaks. It would work better if the drain tube were firmer, maybe somewhere inbetween where it is now and a foley.

We use flexiseals all the time at my facility. They are wonderful if used properly. Yes you will get some leakage, yet you are supposed to irrigate them at least every shift. I irrigate a bit more frequently, just to prevent leakage. Addl, yes you do have to ensure that the tube is unkinked with each turn, easy with sedated/vented patients more difficult with patients that wiggle.

oMerMero · Jan 23, 2008

The flexiseal is great for loose/watery stool. The company says you don't have to worry about inflating and deflating the cuff, that it will not cause too much pressure inside. The patient needs to have decent rectal tone for it to stay in. They are expensive, but worth it for sick patients with constant watery stool.

meandragonbrett · Jan 23, 2008

We have flexiseal.....or well, we used to...but they took them away from us because they cost so much. Only patients of ours that get flexiseal are ones with private insurance. Otherwise it's just a fecal bag.

mendu · Jan 23, 2008

we are using Zassi Bowlel Managment system. good to stay in place for 29 days, then you need to rest colon for day or two and may insert new one. every shift irrigation with 300-500 cc tap water, there are four ballons: 1- air to seal it at place after insertion, 2 - irrigation, 3- meds, 4- air during irrigation to inflate till filling with tap water; very sufficient, prevent skin break esp from c diff; the only problem we always have when you irrigate system, it always leaks no matter what; otherwise sufficient and good esp for our ICU pt bedridden regarding conditions; you can goggle it as "zassi bowel system".

kukukajoo, LPN · Jan 23, 2008

thank you all so much! I have found three companies and Zassi and Flexiseal are two. I can't remember the other off the top of my head. I NEVER realized they were so expensive and now I understand why they are not used more. $900 for a simple butt cath? Just seems a little outrageous if you ask me.

I was hoping to highlught the Flexiseal one but now I have my doubts I could score a sample for demo purposes...

I am looking into the external systems mentioned here and maybe that would be a better option for an inservice teaching. I think if it is more economical, they are more likely to use them in the future.