Clinical Context
An adult patient with a permanent or temporary stoma (colostomy, ileostomy, or urostomy) presents to a wound/ostomy clinic or outpatient surgery center for routine pouching system maintenance or replacement of peristomal support devices. The clinician assesses peristomal skin integrity, measures the stoma site, and determines that an ostomy ring is needed to create a seal between the stoma and the skin barrier to prevent leakage and protect peristomal skin. The ostomy ring (A4404) is provided as a single-item supply during the visit and is commonly applied by an ostomy nurse, enterostomal therapist, or a wound care nurse. Typical workflow: patient check-in, brief clinical assessment, selection and preparation of the ostomy ring, application to the skin barrier or directly to peristomal skin as indicated, patient education on wear time and replacement, and documentation of item description, quantity, and reason for use in the medical record. Typical sites of service include outpatient wound/ostomy clinics, home health visits, long-term care facilities, and outpatient ambulatory surgery centers. Clinical scenarios include management of leakage with peristomal skin irritation, creation of an improved seal for irregular stoma contours, or routine replacement during a scheduled ostomy supply visit.