Faecal management systems for disabling incontinence or wounds

Protecting the perineum from faecal enzymes and preventing faeces from spreading to wounds has been a major challenge for nurses and doctors. Clinicians whose patients are at risk of faecal contamination of wounds have used various methods and many non-standard devices have been trialled, including: large French urinary catheters; rigid rectal catheters; faecal collection bags; mushroom-tipped catheters; nasopharyngeal airway; pharmacological and dietary interventions; incontinence pads; and barrier creams. An initial literature review identified a number of papers of possible interest, but overall we found that little work has been done to evaluate the various ad hoc devices used to manage faecal incontinence, or indeed to consider more formal, purpose-designed systems, such as the ConvaTec Flexi-Seal® faecal management system (FMS). The purpose of this paper is to consider the use of purpose-designed faecal or bowel-management systems-the ConvaTec Flexi-Seal® FMS and Hollister InstaFlo® and ActiFlo® bowel management systems (BMS)-available in Australia at the time of writing. Overall, the authors believe that such purpose-designed systems are more efficient and cost-effective than other ad hoc measures.