To the Editor
I would like to offer a comment regarding the Ostomy Pouch Wear Time article by Leanne Richbourg, Jane Fellows, and Whitney D. Arroyave. In particular, I am directing my comments to the "Discussion" section, wherein the opening sentence states: "We believe this to be the largest study to directly address the question of wear time[horizontal ellipsis]."
The claim to be the largest study of pouch wear time may be a bit premature if one reviews the research and writings of Lenneberg and Rowbotham, which are nicely captured in their book The Ileostomy Patient: A Descriptive Study of 1425 Persons, published by Charles C. Thomas of Springfield, Illinois, in 1970. Essentially, this book describes their targeted research on pouch wear time for ileostomates from the period of 1958-1962 and comprises the tabulated results of 1,355 ileostomy-only participants.
Ileostomates (650 males or 48% and 697 females or 52%) from the United States and Canada who answered the comprehensive questionnaire, which included pouch wear times, are taken from the table found on page 45 of the book.
On page 42 of the book, Lenneberg and Rowbotham identify three types of "troubles" sufficient to cause an appliance change. They included appliance leakage, odor permeation or leakage of gasses, and skin trouble from stool leakage onto the skin. While these troubles are not necessarily inclusive of all the reasons for changing appliances today, they at least offered up some specific causes and clarity then that appear lacking in the current pouch wear time study.
Perhaps this current study on pouch wear times might be more accurately characterized as a continuing reassessment of pouch wear times 4 decades later. Incidentally, the breadth of the Lenneberg and Rowbotham study has yet to be replicated since. Maybe our contemporary ostomy researchers might want to take a page or 2 out of Lenneberg and Rowbotham and do a comprehensive reassessment of ostomy rehabilitation in the 21st century.
Mike D'Orazio, ET, M Mgt
Ostomy Associates, Broomall, Pennsylvania