We recorded the outcomes and problems associated with stoma site marking which was utilized for the 106 ostomy surgeries performed at our institution’s 3Department of Gastrointestinal Surgery from January 2009 until October 2009．
1．Stoma site marking yielded positive outcomes，particularly with regard to stabilizing the ostomy appliance and reducing skin irritation．
2．Eighty percent of patients for whom stoma site marking was performed devel oped difficulties in stoma management due to surgical complications．Stoma location was problematic in 75％ of patients for whom stoma site marking was performed before surgery．
3．Even if stoma site marking is performed prior to surgery，ostomy control may still be difficult for patients with risk factors，other operations，or changes in the shape of their abdominal wall．

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　　We selected eleven items related to stoma physical condition which are considered relevant with regard to wear time.We found that three of them significantly influence the wear time of stoma appliances．Subjects were 121 ostomy patients at 11 facilities．
　　Mean stoma sizes were as follows：vertical,25.6±5.6 mm;lateral,30.0±6.9mm;height,10.9±8.2 mm;with a mean wear time of 78.9±23.2 hours．
　　We found a significant quadratic relationship（p＝0.028）between stoma height and wear time,with a maximum wear time of 83.9 hours at a stoma height of 15.9 mm.Lateral stoma size and wear time were inversely related,whereby a longer lateral stoma size yielded a shorter wear time．
　　The wear time for a circular stoma was 84.2 hours, which was significantly more than that for an oval stoma was73.6 hours（p＝0.011）.

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Objective:The present study aimed to determine the efficacy of team-based outpatient education prior to ostomy.Methods:Subjects included 83 patients who had undergone intestinal ostomies.The post-introduction group（n＝43 patients）received team-based outpatient education prior to ostomy,while the pre-introduction group（n＝40 patients）received conventional pre-ostomy education following admission.We assessed length of hospitalization,length of postoperative hospitalization,time to selfcare implementation, and the number of times the ostomy device was changed.Results:Time to self-care implementation was significantly shorter for the post-introduction group relative to the pre-introduction group（8.7±3.2 days vs.13.4±6.2 days,respectively;p＜0.001）.In addition,the number of ostomy device changes until selfcare implementation was lower in the post-introduction group relative to the pre-introduction group（3.6±1.3 vs.4.9±2.1 changes;p＜0.001）.No significant differences were evident for length of hospitalization or length of postoperative hospitalization.Conclusion:Team-based outpatient education prior to ostomy contributed to earlier self-care implementation following surgery．

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While an accurate understanding of the abdominal subcutaneous fatty layer is important for proper stoma formation and care,a precise investigation of this has not yet been conducted.The present study aimed to investigate the thickness of the abdominal fatty layer in various physical positions and to make recommendations regarding good stoma formation.
Subjects included 24 healthy women aged 40-61 years.After marking the stoma sites in the left upper and lower abdomen，we used ultrasonography to measure the thickness of the abdominal subcutaneous fatty layer at the two points in the following five positions：supine,standing,vended standing,sitting，and vended sitting.
The fatty layer was thinnest in the supine position,and thickest in the vended sitting position．Relative to the upper abdomen,the lower abdomen had a thicker fatty layer in several positions.Gaps of the thickness between the position and supine position were larger in lower abdomen.These gaps were more remarkable in the lower abdomen in subjects with higher body mass index（BMI）values.
In conclusion,sufficient intestinal length in the abdominal subcutaneous fatty layer is essential to prevent stoma retraction.We would also recommend stoma fomlation in the upper abdomen for subjects with high BMI.

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