A stomal therapists experience of a novel chyme reinfusion device for high output enterostomies: A case series instituting a novel chyme reinfusion device in three patients

Abstract

Background: Reinfusing chyme down the distal limb of an enterostomy is a well-researched technique for helping prevent dehydration and electrolyte loss from a high-output enterostomy. However, it has not gained traction because it is a labour-intensive task that requires nursing management and further in-hospital care. A novel chyme reinfusion device that a patient can manage is now available (The InsidesTM System, The Insides Company, New Zealand). Cases: This paper explores a stomal therapist's experience instituting The InsidesTM System for three patients with high output enterostomies. The reinfusion device is a simple set-up that has been shown to reduce fluid and electrolyte imbalances, reduce and remove the need for parenteral nutrition and is patient managed. Patient experience and learning points gained from the three participants were collected across the themes of patient consent, education of patients and carers, custom tube installation into the distal limb, usability testing and feedback to the device developers. Conclusions: The novel chyme reinfusion device is a simple patient-managed solution that is easy to install and initiate. Clinical benefits include preventing dehydration and electrolyte loss from high-output double enterostomies. By instituting a thorough supportive follow-up management plan for each patient, there were minimal complications with high patient compliance and satisfaction.