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BMS (Bowel Management System)
It is a catheter that collects feaces from rectum and drives them into sealed collector.
Retention
Cuff
• Pre-distended, low pressure cuff is symmetric over a wide range of
inflation volumes.
• Not rigid and under pressure like Foley-type balloon catheters
• No tip protrusion past cuff as with Foley-type balloon catheters which
have been reported to impinge the anorectal wall
• Sized and shaped to occupy and conform to the distal rectum for extended
indwell without mucosal damage or triggering of the defecatory reflex
Fecal Diversion – Patient Populations
- Decubitus ulcer
- Posterior flap reconstruction
- Intractable diarrhea w/ skin breakdown
- Burn
- Open pelvic fracture
- Pelvic fracture fixation
- Low spine/sacral surgery
- Vaginal reconstruction/resection
- Perineal wound / surgery
- Femoral catheter
- Drain site
- Necrotizing fasciitis
- Above the knee amputation
- Hip disarticulation
- Hip replacement / reconstruction
- Protect wound from complicated vascular procedures with prosthetic
grafts
Transsphincteric
Zone
Unique thin-membrane, lay-flat construction provides:
Large inner diameter for enhanced fecal evacuation
Conformability which prevents continuous sphincter dilation that could
lead to the incontinence often seen upon removal of rigid catheters
Preservation of physiologic sphincter function during use and following
catheter removal
Decreased perception of presence across sensitive and highly innervated
anal canal
Irrigation
Lumen
• Located on catheter tip to allow delivery of irrigants or medications
via the rectum without continually traversing and traumatizing the sensitive
anal canal
One of our cases. The catheter in place. The rectum was filled with gastrographin
to show the retention cuff.
The catheter can be used in any case of prolonged diarrhea, but it is extremely useful in cases of burns, wounds and decubitus ulcers.
Necrotizing
fasciitis. 52 year old diabetic female with history of stroke. No suitable
location for diverting colostomy due to spread of Fasciitis. BMS inserted
to protect wounds from fecal contaminationBMS Systems provided complete
bowel management for 63 days.
45 day follow-up revealed healthy granulation tissue from aggressive wound
care and effective fecal diversion. Catheter removed at 63 days. Patient
resumed normal toilet use without incontinence. Immediate and temporary
non-surgical fecal diversion.
56 year old female bedridden with Cushing’s Syndrome (CS) from steroid
dependent Rheumatoid Arthritis. Admitted with sepsis. High risk population
for wound complications and therefore avoidance of abdominal incision
and diverting colostomy preferable and likely life-saving.
8 day follow-up. Feces effectively diverted from wound and dressings.
32 Day follow-up
Lifesaving fecal diversion. At the very least significant reduction in
morbidity required to treat in standard manner with diverting stoma.
32 Day follow-up
25 year old with 55% BSA burns and severe pain from continually stooling
on burn wounds.BMS was placed after grafts on her anterior thorax failed
due to infection from Pseudomonas (a GI tract organism). BMS was placed
in OR at time of posterior and buttock grafting.
After BMS was placed, despite new donor sites there was an immediate 50%
reduction in pain medication needs. 100% take of new grafts.