Annals of the Royal College of Surgeons of England (1992) vol. 74, 395-396
NEW TECHNIQUES
The 'Jaykay' stoma flange cutter M C Parker MS FRCS
Celia Myers SRN
Resident Surgical Officer
Stomacare Nurse
St Mark's Hospital, London
CAJ King Director
J K Engineering, Barnstaple, Devon
Key words: Stoma; Colostomy; Ileostomy
One of the many difficulties associated with stoma management is that of cutting the hole in the appliance to fit neatly and precisely around the mucocutaneous border. A new stoma flange cutter has been designed which facilitates the cutting or the enlargement of holes in stoma flanges to the exact size required. This equipment may be of use to partialiy sighted or manualiy disabled patients as weli as to those able patients who would prefer an easier method of cutting the hole in their stoma flange. It may also be of use in operating theatres to enable theatre nurses to cut flanges more accurately and quickly for patients with colostomies, ileostomies or urinary conduits.
The 'Jaykay'® type knife type hole cutter (KTHC) is primarily for use with the Convatec® surgicare system 2 and the Hollister® two-piece ostomy system. Other systems may be appropriate for similar use. There are five different models according to the size of hole to be cut. Each model has a range of hole diameters as demonstrated in Table I. The KTHC consists of two main components; the knife cutter assembly and the base assembly on which the flange is mounted with the paper side of the flange uppermost (Fig. 1). The knife cutter assembly has a notched handwheel which is screwed into a post that carries the knife blade assembly. The knife blade assembly houses the knife blade which is protected when not in use by the knife blade protector and the tracking shoe (Fig. 2). There is a slotted screw on this assembly which has to be removed if and when the knife blade requires Present appointment and correspondence to: Mr M C Parker, Consultant Surgeon, Joyce Green Hospital, Joyce Green Lane, Dartford, Kent DAI SPL
Table I. Flange size
Diameter of hole cut
32 mm 38 mm 45 mm 57 mm 70 mm
19.05 mm to 28.57 mm 22.22 mm to 34.92 mm 25.40 mm to 41.27 mm 30.14 mm to 52.37 mm 44.45 mm to 63.50 mm
changing. The knife blades have a long period of life and should only need changing every 6 months on average. To adjust the KTCH to the correct size of hole, the knife cutter assembly must be held firmly in one hand and the handwheel unscrewed anticlockwise two turns. The slotted screw located in the base of the post must be
Figure 1.
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Figure 4. Figure 2.
similarly unscrewed using the screwdriver provided with the set. Also provided is a gauge or measure which should be fitted to the lower end of the post housing the slotted screw. This should then be turned against the tracking shoe so that the lines on the gauge come into line with the knife aperture in the tracking shoe. Once the knife is set at the correct cutting size both the screws are tightened and the gauge removed. To cut the desired hole in the flange, once the correct size has been set, the flange is placed over the central raised portion of the base assembly with the plastic ring of the flange facing downwards. The base of the knife cutter assembly is then inserted into the central raised portion of the base assembly. Holding the flange on the
base assembly with one hand the handwheel is pressed down with the other hand and turned clockwise a full 3600 while maintaining downward pressure (Fig. 3). This results in a perfect circle of specific diameter being cut in the flange. The knife cutter assembly is detached from the base assembly in order to remove the flange which is then ready for application (Fig. 4). The flange sits in close approximation to the patient's stoma, facilitating minml skin excoriation and preventing damage to the stoma itelf so often seen in misfitting stoma flanges.
Comment We have used the 'Jaykay' KTHC with patients with end colostomies, loop colostomies, ileostomies and urinary conduits with singular success. The patients find it easy to use, conveniently small so as to be transportable and quicker than the conventional use of scissors or a hand held blade. The 'Jaykay' KTHC differs from other stoma flange hole cutters, which are limited to the cutting of a single diameter hole only, by having a range of appliances each with a varying adjustable diameter cutter. The KTHC guarantees a clean cut every time by using a blade and can cut the exact diameter hole required time after time. It is suitable for use with most two-piece systems. The authors would like to thank Miss Jill Maybe for her help and expertise in producing the illustrations.
Figure 3.
Received 22 January 1992
NEW TECHNIQUES
The 'Jaykay' stoma flange cutter M C Parker MS FRCS
Celia Myers SRN
Resident Surgical Officer
Stomacare Nurse
St Mark's Hospital, London
CAJ King Director
J K Engineering, Barnstaple, Devon
Key words: Stoma; Colostomy; Ileostomy
One of the many difficulties associated with stoma management is that of cutting the hole in the appliance to fit neatly and precisely around the mucocutaneous border. A new stoma flange cutter has been designed which facilitates the cutting or the enlargement of holes in stoma flanges to the exact size required. This equipment may be of use to partialiy sighted or manualiy disabled patients as weli as to those able patients who would prefer an easier method of cutting the hole in their stoma flange. It may also be of use in operating theatres to enable theatre nurses to cut flanges more accurately and quickly for patients with colostomies, ileostomies or urinary conduits.
The 'Jaykay'® type knife type hole cutter (KTHC) is primarily for use with the Convatec® surgicare system 2 and the Hollister® two-piece ostomy system. Other systems may be appropriate for similar use. There are five different models according to the size of hole to be cut. Each model has a range of hole diameters as demonstrated in Table I. The KTHC consists of two main components; the knife cutter assembly and the base assembly on which the flange is mounted with the paper side of the flange uppermost (Fig. 1). The knife cutter assembly has a notched handwheel which is screwed into a post that carries the knife blade assembly. The knife blade assembly houses the knife blade which is protected when not in use by the knife blade protector and the tracking shoe (Fig. 2). There is a slotted screw on this assembly which has to be removed if and when the knife blade requires Present appointment and correspondence to: Mr M C Parker, Consultant Surgeon, Joyce Green Hospital, Joyce Green Lane, Dartford, Kent DAI SPL
Table I. Flange size
Diameter of hole cut
32 mm 38 mm 45 mm 57 mm 70 mm
19.05 mm to 28.57 mm 22.22 mm to 34.92 mm 25.40 mm to 41.27 mm 30.14 mm to 52.37 mm 44.45 mm to 63.50 mm
changing. The knife blades have a long period of life and should only need changing every 6 months on average. To adjust the KTCH to the correct size of hole, the knife cutter assembly must be held firmly in one hand and the handwheel unscrewed anticlockwise two turns. The slotted screw located in the base of the post must be
Figure 1.
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M C Parker et al.
Figure 4. Figure 2.
similarly unscrewed using the screwdriver provided with the set. Also provided is a gauge or measure which should be fitted to the lower end of the post housing the slotted screw. This should then be turned against the tracking shoe so that the lines on the gauge come into line with the knife aperture in the tracking shoe. Once the knife is set at the correct cutting size both the screws are tightened and the gauge removed. To cut the desired hole in the flange, once the correct size has been set, the flange is placed over the central raised portion of the base assembly with the plastic ring of the flange facing downwards. The base of the knife cutter assembly is then inserted into the central raised portion of the base assembly. Holding the flange on the
base assembly with one hand the handwheel is pressed down with the other hand and turned clockwise a full 3600 while maintaining downward pressure (Fig. 3). This results in a perfect circle of specific diameter being cut in the flange. The knife cutter assembly is detached from the base assembly in order to remove the flange which is then ready for application (Fig. 4). The flange sits in close approximation to the patient's stoma, facilitating minml skin excoriation and preventing damage to the stoma itelf so often seen in misfitting stoma flanges.
Comment We have used the 'Jaykay' KTHC with patients with end colostomies, loop colostomies, ileostomies and urinary conduits with singular success. The patients find it easy to use, conveniently small so as to be transportable and quicker than the conventional use of scissors or a hand held blade. The 'Jaykay' KTHC differs from other stoma flange hole cutters, which are limited to the cutting of a single diameter hole only, by having a range of appliances each with a varying adjustable diameter cutter. The KTHC guarantees a clean cut every time by using a blade and can cut the exact diameter hole required time after time. It is suitable for use with most two-piece systems. The authors would like to thank Miss Jill Maybe for her help and expertise in producing the illustrations.
Figure 3.
Received 22 January 1992
