Along with normal patient management, the following patient management and assessment is recommended for a patient using The Insides® Neo.

Rate of Refeeding

It is recommended a syringe infusion pump is used to reinfuse the patient’s chyme via The Insides® Neo. This ensures the reinfusion is controlled and comfortable for the patient. Each patient will have their own tolerance for the rate of refeeding. As a general guide:

• Use The Insides® Neo every 4-6 hours to withdraw chyme from the ostomy appliance. This full syringe is placed into the syringe infusion pump, and reinfused over the next 4 – 6 hours.
• Depending on the patient’s condition, when the patient starts chyme reinfusing with The Insides® Neo, consider reinfusing half of their output for the first day and discarding the other half.
  • i.e., if they pass 20 ml of chyme in 4 hours, only reinfuse 10 ml over the next 4 hours.
• If your patient has a high output and the refeeding rate is approaching 8-10ml/hour, monitor for signs of reflux from the distal mucus fistula. If there is reflux, reduce the refeeding rate so chyme can be absorbed. Discuss with the clinical team a maximum refeeding rate so that chyme reinfusion is optimised for the patient. This may mean some chyme is discarded initially until the patient can tolerate a higher refeeding rate. The refeeding rate should be reviewed regularly. Reflux can be assessed in the following ways:
  • Chyme can be seen flowing back into the ostomy appliance
  • The volume in the syringe is more than the last time chyme was withdrawn from the ostomy appliance using The Insides® This is due to the refluxed chyme mixing with fresh chyme.

Monitoring Bowel Movements

Patients will likely have a bowel movement within the first three days of starting chyme reinfusion with The Insides® Neo. If a bowel movement has not happened within three days, urgent assessment is required.

Ostomy Appliance

The Insides® Neo couples with a Hollister™ Newborn Pouch “Pouchkins™” 3778 and Coloplast® “Sensura® Mio Baby”. This ostomy appliance must be changed when it leaks and The Insides® Neo must be changed at the same time. The Insides® Neo can be used for up to four days.

Assessment of Pain and Discomfort

Regular assessment of abdominal distention and discomfort is necessary. This should be completed a minimum of every 4 – 6 hours.

Device Troubleshooting

Please refer to the Frequently Asked Questions for troubleshooting The Insides® Neo

‘Coloplast’, ‘SenSura® Mio ’ are registered trademarks of Coloplast Corporation. The use of the trademarks ‘Coloplast’, ‘SenSura® Mio ‘in these instructions is strictly for informational purposes to provide accurate product information to our customers. The Insides Company Limited does not connote any endorsement, affiliation, sponsorship, or approval by Coloplast Corporation. We hereby affirm our recognition of Coloplast Corporation 's exclusive intellectual property rights in the trademark ‘Coloplast’, ‘SenSura® Mio,' and any references to said trademark are made in good faith to truthfully describe the compatibility or usage of their product.

‘Hollister’, ‘Pouchkins™’ are registered trademarks of Hollister Incorporated. The use of the trademarks ‘Hollister’, ‘Pouchkins™‘in these instructions is strictly for informational purposes to provide accurate product information to our customers. The Insides Company Limited does not connote any endorsement, affiliation, sponsorship, or approval by Hollister Incorporated. We hereby affirm our recognition of Hollister Incorporated 's exclusive intellectual property rights in the trademark ‘Hollister’, ‘Pouchkins™,' and any references to said trademark are made in good faith to truthfully describe the compatibility or usage of their product.

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