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WOCN Society Clinical Guideline

Management of the Adult Patient With a Fecal or Urinary Ostomy—An Executive Summary

 Wound, Ostomy and Continence Nurses Society Guideline Development Task Force

Journal of Wound Ostomy & Continence Nursing: January/February 2018 - Volume 45 - Issue 1 - p 50–58
doi: 10.1097/WON.0000000000000396
Ostomy Care

This article provides an executive summary of the recommendations from the Clinical Guideline: Management of the Adult Patient With a Fecal or Urinary Ostomy, published by the Wound, Ostomy and Continence Nurses Society (WOCN Society). It presents an overview of the process used to update and develop the guideline and lists specific recommendations from the guideline. We provide recommendations that include the following topics: stoma construction, preoperative education, stoma site marking, selection of an ostomy pouching system, postoperative education, postoperative management issues, follow-up care after discharge from the acute care setting, health-related quality of life, and stomal and peristomal complications. The intent of the guideline is to provide information that will assist healthcare providers to manage adult patients with ostomies, prevent or decrease complications, and improve patient outcomes. The full text of the published guideline, which includes available evidence supporting the recommendations and a complete reference list, is available in print and as a mobile application from the WOCN Society's online bookstore ( Refer to Supplemental Digital Content 1 (available at: associated with this article for a complete reference list for the guideline.

Task Force members:

Margaret Goldberg, MSN, RN, CWOCN, Task Force Co-Chair, Delray Wound Treatment Center, Delray Beach, Florida.

Janice Colwell, MS, RN, CWOCN, FAAN, Task Force Co-Chair, Advanced Practice Nurse, University of Chicago Medicine, Chicago, Illinois.

Susan Burns, President, United Ostomy Associations of America (UOAA), Kennebunk, Maine.

Jane Carmel, MSN, RN, CWOCN, Program Co-Director, Harrisburg Area Wound, Ostomy, Continence Nursing Education Program, Mechanicsburg, Pennsylvania.

Jane Fellows, MSN, RN, CWOCN-AP, Wound/Ostomy Clinical Nurse Specialist, Duke University Health System, Durham, North Carolina.

Samantha Hendren, MD, MPH, Associate Professor of Surgery, University of Michigan, Ann Arbor, Michigan.

Vashti Livingston, MS, CWOCN, DAPWCA, Kimmel Urology, MSKCC Ambulatory Division, New York, New York.

Charles U. Nottingham, MD, Resident Physician, Section of Urology, The University of Chicago Medicine, Chicago, Illinois.

Joyce Pittman, PhD, RN, APRN-BC, CWOCN, Wound/Ostomy Nurse Practitioner, Indiana University Health, Indianapolis, Indiana.

Janice Rafferty, MD, Professor of Surgery, Chief, Division of Colon and Rectal Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio.

Ginger Salvadalena, PhD, RN, CWOCN, Principal Scientist, Global Clinical Affairs, Hollister Incorporated, Libertyville, Illinois.

Gary Steinberg, MD, The Beth & Bruce White Family Professor and Director of Urologic Oncology, Vice Chairman, Section of Urology, The University of Chicago Medicine, Chicago, Illinois.


Ronald Palmer, Fullerton, California.

Clinical Editor:

Phyllis Bonham, PhD, MSN, RN, CWOCN, DPNAP, FAAN, Professor Emerita, Medical University of South Carolina, College of Nursing, Charleston, South Carolina.

Correspondence: Phyllis Bonham, PhD, MSN, RN, CWOCN, DPNAP, FAAN, 3247 Seaborn Dr, Mount Pleasant, SC 29466 (

No conflicts have been identified in the development of the guideline or this executive summary.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

© 2018 by the Wound, Ostomy and Continence Nurses Society.