Advanced pelvic surgery may result in the formation of a colostomy, ileosto
my, urostomy, or multiples of these stomas. Stomas may be created because o
f a planned therapeutic attack to eradicate cancer or manage complications
arising from treatments or they may be constructed to palliate severe sympt
oms or life-threatening problems. In some instances, fistulae between vario
us organs and the skin may occur. Special skills are required to meet the n
eeds of patients with ostomies or fistulae. The often complex care presents
critical challenges to nurses, particularly in today's cost-conscious heal
th care environment where prompt hospital discharges, brief clinic appointm
ents, and valuable but limited home care visits are the norm. The skills of
the enterostomal therapy nurse are valuable in all phases of care of these
patients, from preoperative to outpatient care. (C) 2000 Wiley-Liss, Inc.