What can contribute to varices around the peristomal skin?

Excessive pressure from occlusive devices can lead to varices around the peristomal skin because it creates a localized area of increased pressure and diminished blood flow. This can cause venous distension and the formation of varices, which are abnormally enlarged veins. When an ostomy appliance is applied too tightly or left in place for extended periods without adequate airflow, the skin and surrounding tissues can't breathe properly, which can lead to vascular complications such as varices.

Other factors mentioned, such as insufficient cleaning of the stoma, frequent changing of the ostomy appliance, and using smaller ostomy pouches, do not directly lead to varices. While they are related to the overall care and maintenance of the stoma site and can contribute to skin irritation or other complications, they do not inherently involve the mechanical pressure or venous issues that provide a direct cause for varices. Therefore, understanding the impact of pressure from devices is critical in preventing additional complications in patients with ostomies.