Concept of abdominal wall stoma: An abdominal wall stoma is an opening of a part of the intestinal tube placed in an appropriate position on the anterior abdominal wall for the purpose of treating a disease, so that it can act as an anus for a short or long period of time, exercising the kinetic energy of defecation, which is often referred to as an “artificial anus”. Once an abdominal stoma has been constructed as a result of a disease, especially if it is a permanent stoma, it is often necessary for the patient to learn to observe and maintain the stoma and to change the anal pouch in order to improve his/her quality of life. The following is a brief introduction to the daily observation of the stoma and self-help replacement of anal pouch knowledge: First, the stoma itself observation: normal stoma of the intestinal mucosa should be red or pink, warm and moist and elastic. If the color of intestinal mucosa is pale, dark red or mauve and the mucosa is dry and inelastic, it is the early manifestation of stoma blood transportation obstacle and local ischemia; if the local area is completely black, it means that the stoma intestinal tube has undergone long term ischemic necrosis, and it needs to be surgically treated. The skin around the stoma should be intact and healthy, and it should be observed whether there are erythema, rash, blister and injury, whether the intestinal mucosa is separated from the skin, and whether there are allergies and infected pus in the skin. If any of the above abnormal conditions are found, the patient should contact the physician and take corresponding medical treatment measures. Observation of stoma function: 1. jejunostomy: usually start to have excretory function 48 hours after operation, the initial outflow is gastrointestinal fluid containing bile, mostly dark green transparent watery material, the amount of 2000 ml per day. 2, ileostomy: 48-72 hours after surgery to start defecation, the initial viscous light green unformed paste-like stool. 3, transverse colostomy: 3-5 days after the operation to start defecation, the discharge of yellowish paste and soft loose stool. 4, descending colon and sigmoid colon stoma: 5 days after the operation began to restore the function of defecation, can be discharged soft molded stool. Third, the artificial anal bag of the correct self-help replacement and steps: 1, replace the anal bag before the anal bag must be ready: disposable anal bag disinfection of the tip of a good cut sterile dressings saline on the mucous membranes without stimulation of the disinfectant zinc oxide ointment, etc.. 2, first of all, the anal bag paste board according to the concentric circles cut out the appropriate size of the round mouth spare. 3, their own in their own habit convenient standing position semi-sitting position or sitting position, as far as possible the idea of discharging the stoma near the section of the intestinal tract of the stored stool contents, so as not to change the operation out of the operation to avoid annoying operation, pollution of the local. 4, the left hand pressure abdominal wall, the right hand to uncover the original anal pouch paste board, note: to the left hand gently push the abdominal wall skin of the main force, do not right hand force tearing, so as to avoid epidermal avulsion injury. 5. Clean the intestinal mucosa of the stoma with a cotton ball or a small cloth soaked in saline and wrung out, and clean the liquid in the intestinal lumen at the proximal end of the stoma, so as to avoid overflowing and contaminating the skin in the process of replacing the stoma, which may hinder the replacement of the stoma. 6.Clean the skin around the stoma with non-irritating disinfectant and saline, if there is any dermatitis, eczema or erosion, it should be treated accordingly, and apply zinc oxide ointment locally after the skin is dry and clean. 7, will cut the mouth of the anal pouch plate removal of the protective film aligned with the fistula mouth tightly smoothed, and hand equalization force pressure about half a minute to prevent leakage of the paste is not tight and leakage or anal bag off. The bag facing down, clip the tail bag. 8, usually bathe with waterproof film to protect the anal pouch, to prevent water seepage into the anal pouch paste board. When the anal pouch filled up to one-third should be replaced when the anal pouch. Conditional recommendations: remove the original anal pouch before bathing, bathing can be optional for artificial anal cleaning or even self-help enema to clean the intestinal tract, empty intestinal contents, bathing is completed after the installation of the new anal pouch.