Peristoma complications case sharing

Sharing a case I saw in a client group. On Tuesday morning, Ms. Lu found a lot of granulation around the stoma with bleeding, so she came to consult our stoma nurse. The following is the shape of Ms. Lu's stoma, as shown in the picture below:

Assess Ms. Lu's stoma and surrounding conditions:

①The shape of the stoma is flat, and exudate leakage is easy to occur.

②The skin around the stoma was dark red with some red spots.

③ There is granulation tissue around the mouth with hemorrhage.

Know your stoma shape and choose the right stoma product:

Stoma leakage is a frequent headache for stoma friends, and changes in the shape of the stoma can also lead to leakage and complications around the stoma. Below, please come with me to understand what stoma forms are and how to deal with them:

Stoma shape:

Flat stoma: The shape of the body around the stoma under the chassis is flat relative to the rest of the abdomen.

Stoma retraction: The body shape around the stoma under the chassis is retracted or depressed relative to other parts of the abdomen.

Stoma bulge: The shape of the body around the stoma under the chassis is convex relative to the rest of the abdomen, forming a bulge.

Depending on the shape of the stoma, the stoma products you choose are also different. As shown in the picture, Ms. Lu's stoma is flat, so Longterm Medical convex ostomy bag is suitable for choosing stoma products, and Longterm Medical Ostomy Belt can also be used together. A slightly lower raised stoma tray would be more helpful.

Skin care recommendations around the stoma:

① Stop using accessories that contain alcohol. such as alcohol-containing protective film

②Clean the surface of the stoma well, and then rinse it with clean water. Only after cleaning can the stoma bag be attached.

③You can use Longterm Medical Skin Protective Power to spray on the skin around the stoma, apply it evenly, and remove the excess powder after 3-5 minutes of absorption. If there is residual powder on the broken skin, it can be left directly on it. Skin Protective Power can absorb the ulcer, keep the skin dry, and help repair the broken skin.

④Longterm Medical Anti leakage strip can be used to cover the ulcerated skin surface around the stoma (it can isolate the effect of the skin at the ulceration on the adhesion of the chassis. It can help to stick the ostomy bag and prevent urine from directly contacting the chassis and skin)

⑤Choose a two-piece convex chassis, and cut the diameter of the chassis reasonably. The diameter of the chassis can be 1~2mm larger than the actual diameter of the stoma. It can be tightened and fixed with a special belt for the stoma to avoid leakage of urine.

Granulation tissue around the stoma:

①When the mucous membrane and the skin are in contact, check whether there are sutures around the stoma that have not fallen off, remove the sutures, and then use the corresponding stoma care products, correctly paste the ostomy bag, and protect the wound from contamination.

②The size of the stoma should be measured correctly to avoid frequent friction between the chassis and the edge of the stoma, resulting in granulation hyperplasia.

③ Granulomas less than 0.5cm can be cauterized with silver nitrate, and you can contact a doctor for operation.

④ For larger granulomas larger than 0.5cm, high-frequency electric cauterization can be used, and the doctor should be contacted for operation.

Precautions to prevent peri-ostomy complications:

1. When pasting the ostomy bag, the chassis is pressed against the skin, and the skin around the stoma must not be exposed. Generally, after the secretion is collected, the surrounding red and ulcerated skin will recover in about half a month.

2. Do not use flat or non-adhesive ostomy bags. To avoid the skin around the stoma from being soaked again, it is best to choose a deep convex two-piece ostomy bag.

3. It is not recommended to use zinc oxide ointment, because zinc oxide ointment is oily, after applying it, the stoma pocket cannot be sticky, and the secretions soaking the skin will form a vicious circle.

For more information on Innomed® dressing, refer to the previous articles. If you have customized needs, you are welcome to contact us; we will serve you wholeheartedly.

At Longterm Medical, we transform this data by innovating and developing products that make life easier for those who need loving care.

Editor: kiki Jia

Date: September 16, 2022