After the creation of a loop transverse colostomy, what is the best action if the stoma is protruding significantly during a home care visit?

Selecting a pouch with a convex system is the most appropriate action when dealing with a significantly protruding stoma following the creation of a loop transverse colostomy. A convex pouching system is specifically designed to provide additional support for stomas that may be retracted or protruding. The contour of the convexity helps to create a secure seal around the stoma, which minimizes the risk of leaks and enhances adherence, especially for stomas that do not sit flush against the skin.

Additionally, a convex pouch can also help manage the potential for herniation. Herniation can occur when the intestinal segment pushes through a weakness in the abdominal wall, and a convex pouching system helps to stabilize the stoma by applying gentle pressure around it, thereby reducing this risk. This is particularly important for patients with protruding stomas, as the added support can mitigate complications and contribute to the overall health and comfort of the patient.

The other options may have their own merits in certain situations but do not directly address the immediate concern of a protruding stoma as effectively as the use of a convex system does.