Case sharing after ostomy

Many patients who have just completed ostomy operations are still unfamiliar with the operation of ostomy care, so they are prone to post-ostomy complications. Leakage of the ostomy is one of the most common complications. If this happens, immediate action should be taken. Measures to avoid causing peripheral dermatitis. Then follow me to look at a case of colostomy leakage.

case:

The patient was a 55-year-old woman who had previously undergone surgery for colon cancer. A few days ago, the patient suddenly developed abdominal pain and diarrhea at home, and the excreted feces had a lot of fishy smell. The patient was rushed to the hospital for treatment.

After a detailed examination, doctors found that the patient's colostomy site was leaking, causing a large number of intestinal contents to leak out of the stoma. In addition, the patient is also accompanied by symptoms such as abdominal distension and high fever.

How to treat:

1. Drainage: Drainage at the wound through a tube to drain out the dirt that has leaked out of the intestinal contents to reduce the risk of infection.

2. Anti-infection treatment: Oral or intravenous antibiotics to prevent the spread of infection and remove the focus of infection.

3. Appropriate nutrition and supportive therapy: The patient's intestinal function is severely impaired due to symptoms such as diarrhea and vomiting, so it is necessary to maintain the body's energy and metabolic needs through intravenous infusion or nutritional support.

4. Keep the skin around the stoma dry: Because the stoma is prone to infection, the stoma bag needs to be replaced regularly to keep the skin around the stoma clean and dry. In addition, the doctor will regularly observe the condition of the wound to ensure the healing process of the wound.

What are the common causes of stoma leaks:

1. Improper patient care:

The patient and his/her family members have not mastered the correct stoma care techniques. It should be noted that when replacing the stoma bag, the skin around the stoma is not cleaned. Leakage occurs due to uneven adhesion between the chassis and the skin.

2. Changes in the patient's body shape:

The weight of the patient changes. If the weight increases or the patient becomes thin, the shape of the abdomen will lead to changes in the stoma. If the original method is used, it will easily affect the stability of the stoma chassis.

3. The replacement of ostomy bag related products is not timely:

If the excrement is water sample, it can be cleared when the bag body is 1/3 full, and if the excrement is solid, it can be cleared after each excretion. For patients with excessive gas, try to eat food with less gas production, and choose an ostomy bag with carbon sheets.

The stoma chassis has a service life. It is recommended to replace it every 3 to 5 days, and the longest should not exceed 7 days. If there is leakage, it needs to be replaced in time.

Correct nursing method:

daily stoma accessories: stoma powder, skin protectant (or liquid dressing), leak-proof ointment, glue remover, and stoma ruler.

1. Clean the skin around the stoma with warm water;

2. Use the Ostomy Measure Card to measure the size of the stoma, and cut a suitable chassis. Under the premise of not strangling the stoma, the center hole of the chassis of the ostomy bag should be as close as possible to the stoma, and the edge should be about 1mm;

3. Sprinkle Skin Protective Powder evenly around the stoma, spread it evenly with a cotton swab, and then wipe off the excess floating powder; Skin Protective Powder can protect the skin of the stoma. If the surrounding skin is damaged, red, swollen, and inflamed, Skin Protective Powder can also be used.

4. Apply the stoma Skin Protective Spray on the skin (or spray the liquid dressing around the stoma), the Skin Protective Spray will form a waterproof protective film on the skin surface, which can isolate the skin from fecal water stimulation and has no effect on the skin adverse effects. (If a family has skin problems, Skin Protective Powder and Skin Protective Spray can be used alternately 2-3 times to increase the protective effect.)

be used around the stoma: on the one hand, it can fill up the depression or uneven skin usage time.

6. In the supine or standing position, press the chassis from bottom to top with your hands and press it with your hands for 5-10 minutes after pasting, which can increase the stickiness of the ostomy bag.

7. When tearing off, hold the skin with one hand, and gently tear it off from top to bottom with the other hand. It is recommended to use glue remover. It will be easier to tear off after spraying on the chassis a few times, and it can also remove excess glue.

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

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Editor: kiki Jia

Date: March 31, 2023