Stoma care

Basic information of Stomas
Diseases requiring a colostomy: Rectal cancer, colon cancer, familial polyposis, intestinal trauma, intestinal inflammation, obstruction, intestinal necrosis, anastomotic fistula, bladder cancer.
Single-lumen stoma
Loop stoma
Double-port stoma
Separate stoma

Based on the intestinal segment where the stoma is located, it can be classified as follows:
Ileostomy
Ceco-stomy
Ascending colostomy
Transverse colostomy
Descending colostomy
Sigmoid colostomy

Based on the purpose of the stoma, it can be classified as follows:
Temporary stoma
Permanent stoma

Changing the Ostomy Bag
Supplies:
One-piece (or two-piece) open ostomy bag
Ostomy tray
Skin care powder
Leak-proof ointment
Bag scissors
Ostomy scale or ruler
Normal saline or warm water (200ml)
Paper towels
Bent basin or two garbage bags
Sheet

Order of changing ostomy bags：
(1) Expose the stoma site and place a sheet on the side of the stoma.
(2) Remove the stoma bag and discard it in a waste bag.
(3) Clean: Clean the stoma and the skin around it from the inside out and in a circular pattern.
(4) Assess whether there are any complications with the stoma and the skin around it. If so, treat them promptly.
(5) Measure the size of the stoma.
(6) Cut the size of the stoma base opening: The size of the stoma base opening is generally 2-3mm larger than the size of the stoma.
(7) Apply skin care powder: Prevent skin infection caused by irritation from the stoma fluid.
(8) Apply anti-leakage ointment: It can better prevent leakage of fluid from the stoma.
(9) Paste the stoma base.
(10) Put the stoma bag on the stoma base.
(11) Clean the supplies.
(12) Record the patient/family's participation in bag change, stoma size, shape, whether there are complications, and treatment methods

Complications of the stoma and surrounding areas:
Stoma bleeding, enterostomy ischemia and necrosis, enterostomy retraction, stoma stenosis, stoma prolapse, separation of the enterostomy mucosa from the skin, and peristomal skin complications.

Prevention of Stoma Complications
Prevention of stoma complications is crucial, and the key lies in improving stoma quality. A detailed preoperative examination and careful surgical planning based on the patient's specific circumstances are essential. The stoma site should be carefully selected, and the appropriate stoma diameter should be chosen based on the intestinal diameter. Thorough hemostasis should be ensured. Early observation and timely, targeted symptomatic treatment can reduce the incidence of complications.

Health Education for Stoma Patients
Wash the skin around the stoma with a soft towel and warm water, scrubbing from the inside out. Do not use soap or disinfectant. Wear loose clothing and shower. Patients can participate in appropriate physical exercise based on their preferences and physical endurance, but avoid strenuous activity and minimize bending to protect the stoma.