In recent years, the incidence of colorectal and bladder cancer has shown a continuous increase, and stoma surgery, as one of the important means of treating the disease, has also led to a rising trend in the number of stoma patients. Colostomy surgery is one of the most commonly performed surgical procedures and is often an important means of saving lives, extending life and improving quality of life.
Various stoma complications often occur after colostomy surgery, which not only aggravate the patient’s pain and increase the financial expenses, but also seriously affect the patient’s quality of life after surgery. Patients are taught how to perform self-rehabilitation care during the recovery phase of treatment after stoma surgery and how to care for themselves in the face of common problems in home care.
Stoma care instructions
1. How to clean the stoma and its surrounding skin?
Use gauze, toilet paper, wet paper towels, or cotton balls to wipe with warm water, wipe from the inside out, and then dry thoroughly. There is no need to use alkaline soap or any disinfectant, they will dry out the skin and easily damage it, and will affect the adhesive power of the mucosa.
2. Causes of skin redness and swelling around the stoma and care measures
① The prolonged impregnation and irritation of the skin by stool causes irritant dermatitis, also known as fecal water dermatitis. When stoma bag, the chassis cut must be the right size, such as cut too large, the stoma and the chassis will be stored between the stool, causing skin irritation, such as cut too small, will rub the intestinal mucosa and even cause bleeding. Therefore, the best size is to cut the sump to 1~2mm larger than the stoma.
② Frequent changing of the stoma bag, or forcibly peeling off the stoma bag caused by. The adhesive should be peeled off gently and slowly to avoid frequent replacement of stoma products. General two-piece stoma chassis use time is 5 ~ 7 days, a one-piece use time of 1 ~ 3 days.
③ Body hair around the stoma is too dense, or sweating causes folliculitis or eczema. Body hair should be removed before affixing.
④ Allergic dermatitis caused by skin allergy to viscose components can be applied with anti-allergic ointment, while changing the type of stoma bag or using skin protective film, but pay attention to wipe the anti-allergic ointment clean before pasting the new stoma bag, otherwise it will affect the pasting of the stoma bag.
3.What about bleeding on the surface of the stoma?
The mucosa of the stoma is rich in capillaries, when changing the stoma bag or cleaning the stoma, sometimes the blood vessels will be damaged causing a small amount of bleeding, you only need to use clean tissue or cotton balls to slightly compress to stop the bleeding. However, if the bleeding continues or the color is abnormal, or if there is blood flowing from the inside of the stoma, you should see a doctor or go to the stoma clinic for consultation.
4. What should I do if the skin around the stoma bulges?
After stoma surgery, weak abdominal muscles or persistent increase in abdominal pressure may lead to abdominal bulging at the stoma site, which is medically called “stoma hernia”. For mild stoma hernia, a two-piece stoma bag with a lap band can be used to relieve the pressure on the abdomen. For severe stoma hernias, use a one-piece ostomy bag to increase the adhesive strength. Also consult your stoma clinic or surgeon. Avoid actions that increase abdominal pressure in daily life, such as lifting heavy objects, persistent coughing, etc.
5.What should I do if the stoma is protruding more and more?
Due to various reasons such as increased abdominal pressure and fixation of the intestinal tube, the abdominal muscles become weak, resulting in the intestinal tube
The stoma protrudes and grows, which is called “stoma prolapse”. Mild prolapse can be handled without treatment or pushed back into the abdomen by hand, while severe prolapse can cause edema, bleeding, ulcers or even intestinal torsion and other adverse consequences.
6.How to choose the right ostomy bag for you?
At present, there are two major categories of ostomy bags sold in the market, one is called one-piece ostomy bag, and the other is called two-piece ostomy bag. The two types of ostomy bags are subdivided into open or closed ostomy bags, transparent and opaque ostomy bags, ostomy bags with activated carbon tablets and ostomy bags without carbon tablets. If the patient’s stoma is the right size and the surrounding skin is intact and flat, then you can choose either type of ostomy bag.
If the stoma is transverse colonic, you may want to choose a slightly larger diameter ostomy bag for the stoma chassis. Patients can choose one or several stoma pouches suitable for them according to their skin condition, economic situation, different living environment, convenience of use, etc. The stoma bag should be kept indoors and out of direct sunlight.
Instructions for daily life of stoma patients
1. Protect the skin around the stoma. The skin around the stoma can become red, swollen, painful or even ulcerated when stimulated by stool. Therefore, it should be kept clean and dry. Once ulcers appear, skin care products such as protective film and protective powder should be selected according to the skin condition.
2, should often check whether the stoma bag paste is secure, especially out on, off, sports, before going to sleep should empty the stoma bag, to avoid the contents of the bag in the activity, turn over when the spill. Usually should carry a spare bag, especially when the stool is thin.
3, clothing should be soft, loose, comfortable for the principle, the belt should not be too tight, do not press the stoma.
4. Bathing does not damage the mucous membrane of the stoma and water will not enter the body through the stoma, so there is no need to cover the stoma in either shower or tub bath. If you cover the stoma with the stoma bag when you take a bath, it is recommended to replace the stoma bag with a new one after bathing. When swimming, you can use a mini bag or stoma pessary at the stoma, and a one-piece one-piece swimsuit is appropriate for female patients.
5. Enterostomates cannot fully control the defecation process like normal people, so the issue of diet is also a major concern for stoma patients. Some people think that restricting dietary intake can reduce the amount of excretion to reduce the inconvenience caused by the stoma, but this often leads to more problems, such as excessive restriction of diet in cancer patients after surgery will slow down the body’s recovery and put the organism in a bad state to affect the wound healing. In fact, colostomy surgery will not affect the digestion and absorption of food, so there is no need to make special changes in diet, and a balanced diet is sufficient.
6. After stoma surgery, as long as energy allows, you can still participate in work, and the stoma itself will not affect work. However, frequent lifting of heavy objects should be avoided to avoid the occurrence of stoma hernia.
7. After the body has fully recovered, you can participate in non-strenuous sports activities, such as pool, bowling, cycling, jogging and traveling. However, strenuous activities should be avoided and care should be taken to avoid damage to the stoma during the activities. If you go on a trip, remember to bring enough stoma care products and carry them with you for easy replacement.