Colostomy is an opening to forma stoma.it is made during surgery to divert faeces from the anus. It opens to the abdominal wall.
Stoma.Is the opening into the skin where a pouch for collecting faeces is attached
in short colostomy care is the care for the stoma/colostomy
Indications
- Cancer of the colon because passing stool through the ractum can cause bleeding and ulceration during passing stool.
- When a section of the colon has been removed, making it shorter, this could be due to cancer
- Preparation for children. Children to undergo intensive pelvic surgery
- Injury to the colon
- intestinal/bowel obstruction
- An operation on the colon to give it time to heal
- Congenital abnormalities
- Diverticulitis
Importance of Performing Colostomy Care
- Prevents Skin from Infection and irritation. Regular cleaning and correct fitting protect the skin surrounding the stoma from stool leakage, which can cause redness and pain.
- Prevents Leakage and Odour. When the colostomy bag is fits well, it reduces stool leakage that can cause unpleasant odour. This improves comfort and confidence.
- Promotes Patient Comfort. Regular care reduces itching, pain, and discomfort around the stoma.
- Prevents Complications. Correct colostomy care helps prevent complications, for example, skin breakdown, stoma prolapse, and retraction, blockage, and hernia
- Promotes Hygiene and Cleanliness Colostomy care maintains a clean environment, which supports overall hygiene and reduces the risk of contamination and illness
- Improves Quality of Life. When colostomy care is done properly, patients feel more confident socially and emotionally, improving self-esteem and daily functioning. This is achieved through counselling
- Encourages Independence and Self-Care. Teaching proper care empowers patients to manage their colostomy independently, reducing dependence on caregivers.
- Supports Early Detection of Problems. Regular stoma care allows early recognition of changes such as swelling, bleeding, or colour changes by observing these, enabling early medical intervention
- Reduces Hospital Visits and Costs. Proper care minimizes com plications that may require medical treatment or hospital readmission.
- Enhances Psychological Well-Being. Good colostomy care reduces anxiety, fear, and embarrassment related to leakage or odour, supporting
Requirements for colostomy care
It is a trolley and the procedure is clean not a sterile procedure
Top shelf
- Soap in a soap dish
- Barrier cream
- Bowl of warm water
- Disposable glove
- Galipot of swab or gauze
- Tape measure
- Clean scissors
- Lotion ball in galipot
- Colostomy bag in the bowel
Bottom shelf
- Aprons
- Towel and mackintosh
- Large receiver
- Measuring jar
Bedside
- Hand washing eqipments
- Screen
Procedure
- Explain the procedure to the patient to inform him of what will be done. This will allay his/her anxiety
- Using the screen to cover the bed to provide privacy and comfort
- Bring the trolley to the bedsite for easy access to the equipment
- Put on an apron to protect the nurse’s uniform from any splush
- Position the patient in a recumbent position for easy work
- Wash your hands with soap and water to prevent cross-infection
- Protect the bedding using the Mackintosh and a towel by putting it under the patient
- Turn down the bedding on top for access to the stoma
- Gently remove the soiled bag using the cotton, taking care of the skin not to pull the skin
- Using water and soap, wash around the stoma and dry it well
- Apply barrier cream to protect the skin from being burned by the faeces
- Remeasure the stoma and make correct measurements
- Cut the correct size of the cycle in the stoma adenshive
- Apply a clean bag
- Thank the patient for cooperation and leave the patient comfortably
- Clear away
- Wash hand
- Record the procedure
Complications colostomy
- Peristomal skin irritation patient presents with redness, itching, pain.
- Skin infection ie swelling, discharge, foul smell, or broken skin
- Stoma prolapse, the stoma becomes longer and protrudes more than normal.
- Stoma retraction: the stoma sinks below skin level
- Stoma necrosis, dark, black, or pale stoma due to poor blood supply (serious complication)
- Stoma oedema: swelling of the stoma, especially after surgery
- Constipation: reduced or hard stool output.
- Diarrhoea: frequent watery output leading to dehydration
- Bowel obstruction: no stool output, abdominal pain, nausea, vomiting
- Peritoneal hernia
- Anxiety, depression, low self- esteem
- Social withdrawal due to fear of leakage
- Frequent pouch detachment
Advice on discharge of the patient with a colostomy/stoma
- Rehydration: tell the patient to take a lot of fluid, that is water, juice,yogat to prevent constipation.
- Diet adviced the patient to eat a well-balanced diet to promote faster healing
- Do light exercises like walking this help to tighten the muscle and prevent retraction
- Avoid overstraing excersice eg heavy lifting.
- Keep good personal hygiene to prevent infection from setting in.
- Avoid tight clothes to prevent pressure on the stoma
- Don’t isolate yourself from people. This is good for psychological treatment
- Shaw the patient how to care for colostomy
- Encourage Follow-up review
- Teach the patient signs and symptoms of complication like readyness,fever,pus ,no stool coming
- Advise the patient to report in case of signs and symptoms of complication