Addressing the GAPS in Stoma Output Monitoring

It has been estimated that there are some 200,000 ostomates in the UK, with over 20,000 new stomas created each year and while there have been substantial advances in surgical procedures, complications post discharge remain considerable. High output volumes of ileal fluid are of particular concern where they can lead to dehydration and can greatly increase the risk of readmission. The standard approach of measuring stomal output via a measuring jug is largely incompatible with normal everyday life especially where the patient is attempting to re-establish their pre-surgery social or occupational activities. While there is now considerable interest in the development of smart pouch systems that can provide an early warning of leak events, none have the diagnostic capability to monitor the output from the stoma nor its composition. This is significant as changes in stoma pH can will be a factor in increasing erosion of the pouch adhesive leading to moisture associated skin damage (MASD) which increases the likelihood of leakage. MASD is another critical contributing factor to readmission and a major concern for ostomates. Integrating sensors within the stoma collection pouch that autonomously monitor both stoma output and pH would provide a much more consistent and diagnostically rich approach and would be invaluable in identifying emerging trends in stomal output caused by enteric infection, obstruction or recurrent / active inflammatory bowel disease. It could be envisaged that alongside dietary diaries, the pH / output telemetry would also assist in providing smarter, more analytically robust solutions to minimising skin complications. The aim of the proposed programme is to investigate the efficacy of a new sensing approach based on laser induced graphene that could speed the development of smart pouch systems.