Question: Understanding the Effectiveness of Hernia Support Belts With and Without Holes in Ostomy Care

I recently learned that in Europe, hernia support belts with holes for the pouch are not typically recommended, in contrast to North America where they seem more common. The concern is that belts with holes might exacerbate the hernia issue they are meant to address. However, I’ve heard from some users of hole-less belts that they occasionally face issues with output flow into the pouch, requiring discreet manual assistance. Could you provide insights into this debate and recommend resources for further information?

Response: Navigating the Hernia Belt Debate in Ostomy Care

Thank you for your insightful query regarding the use of hernia support belts in ostomy care and the varying practices between Europe and North America.

The debate over whether to use hernia belts with or without holes is indeed a significant one in the field of ostomy care. The primary concern with belts that have holes is the potential for exacerbating the hernia – a condition these belts are designed to manage.

Key Resources for Further Information:

NSWOC (Nurses Specializing in Wound Ostomy and Continence) Resources: The NSWOC provides comprehensive articles and guidelines on parastomal hernia care. A notable article that delves into this topic can be found here: NSWOC Parastomal Hernia Article. Additionally, Parastomal Hernia Prevention, Assessment, and Management: Canadian Best Practice Recommendations is available here.

  1. WOCN (American Wound Ostomy Continence Nurses) Guidelines: The WOCN offers guidelines that can be accessed here. This document is a valuable resource, and I recommend reviewing the references at the end for further studies.

Key Considerations:

  • Pouching System: The choice between a hernia belt with or without a hole often depends on the type of pouching system used. Some articles suggest that flexible pouching systems work better with hole-less belts, reducing the risk of “coning” where the abdominal wall pushes through the hole.
  • Type of Stoma and Hernia Belt: In cases where a more rigid pouching system is used, such as a two-piece system or a system with convexity, hernia belts with holes might be effective. However, it’s crucial to ensure the hole size matches the pouching system and monitor the skin for any pressure injuries.
  • Personal Experience and Preferences: Ultimately, the choice of hernia belt (with or without a hole) should be tailored to the individual’s needs, stoma type, and the specifics of their pouching system.

I hope these resources and considerations assist in making an informed decision regarding the use of hernia support belts in ostomy care. For personalized advice, I highly recommend consulting with an NSWOC professional. You can find a local specialist via the NSWOCC Find a NSWOC page.

Warm Regards,

Andrea Manson RN, BSN, NSWOC, NCA
Retired Healthcare Professional