Guide of OstomyCare

A Comprehensive Guide of Ostomy Care

An ostomy is a surgically created opening (stoma) in the abdomen that allows for the discharge of body waste (stool or urine) into an external pouch (ostomy pouch or appliance) instead of the usual pathway.

1. Key Terminology

· Stoma: The actual opening on the abdomen. It is moist, red or pink, and has no nerve endings (so it's not painful to touch).

· Ostomy Pouch / Appliance: The bag that collects the waste. It consists of:

  · Barrier / Wafer / Flange: The part that sticks to the skin around the stoma. It protects the skin.

  · Pouch: The bag itself, which can be drainable (for Ileostomies/Colostomies) or closed (for some Colostomies).

· Types of Ostomies:

  · Colostomy: Connects to the colon (large intestine). Output is usually more formed.

  · Ileostomy: Connects to the ileum (small intestine). Output is liquid to pasty and contains digestive enzymes that can irritate the skin.

  · Urostomy / Ileal Conduit: Diverts urine. A small section of intestine is used to create a stoma, and urine constantly drains.

· Peristomal Skin: The skin surrounding the stoma. Its health is critical.

2. Essential Steps for Pouching System Change

A regular and correct pouch change is the cornerstone of ostomy care.

Supplies Needed:

· New pouch system (barrier & pouch)

· Stoma measuring guide

· Scissors

· Skin prep wipe (e.g., a no-sting barrier film)

· Adhesive remover wipe/spray (optional but helpful)

· Moist cloth or paper towel

· Plastic bag for disposal

Procedure:

1. Prepare: Gather all supplies. Wash your hands thoroughly.

2. Remove Gently: Carefully peel the old barrier away from the skin, pushing the skin down rather than pulling the appliance up. Use adhesive remover if needed.

3. Clean: Clean the stoma and surrounding skin with warm water and a soft cloth. Do not use soap, oils, or alcohol near the stoma as they can interfere with adhesion and irritate the stoma. The stoma may bleed slightly when cleaned—this is normal.

4. Inspect: Check the stoma (it should be red and moist) and the peristomal skin for any redness, rash, or sores. Check the discarded appliance for any signs of leakage under the barrier.

5. Measure & Cut: Use the measuring guide to check the size of your stoma. It can change size after surgery. Trace the correct size onto the back of the new barrier. Cut the hole. The hole should be no more than 1/8 inch (2-3mm) larger than the stoma to prevent skin exposure to output.

6. Prepare Skin: Let the skin air dry completely. Apply a skin prep wipe and let it dry until tacky. This protects the skin and improves adhesion.

7. Apply: Remove the backing from the new barrier. Press the appliance firmly onto the skin, ensuring a good seal around the stoma. Hold your hand over it for 30-60 seconds to warm it and activate the adhesive.

8. Close the Pouch: If using a drainable pouch, remember to close the end securely.

Frequency: The pouch is typically changed every 1 to 4 days. Do not wait for a leak to change it. A good time is when output is less active, often first thing in the morning before eating or drinking.