The document discusses the care of patients with ostomies, including defining an ostomy as a surgically created opening in the abdomen that brings part of the bowel to the outside of the body. It describes different types of ostomies like colostomies and the purposes and procedures for colostomy care, which involves changing disposable pouches to collect waste and caring for the stoma and surrounding skin. The document also provides home care considerations and resources for patients with ostomies.

1. CARE OF PATIENTS
WITH OSTOMIES

2. Ostomy- definition
 It means an opening which is made during
surgery that brings a piece of bowel
(intestines)to the outside of the abdomen.
 Ostomy surgeries are performed when a part
of the bowel is diseased and therefore is
removed

3.  The artificially created opening is called
stoma.
 The output from the stoma (urine, feces or
mucous ) is called effluent

4. Characteristics
of stoma
Protrudes
above the skin
Pink to red in
colour
Moist
Round in
shape
No nerve
sensations

5. Colostomy
 It is an operation in which an artificial opening
is made into the colon on the anterior
abdominal wall to permit the escape of feces
and flatus

6. Indications for colostomy
 Cancer of colon & rectum
 Bowel obstruction
 Crohn's disease
 Ulcerative colitis
 Hirschprung's disease
 Imperforate anus

7. Purposes of colostomy
 To permit escape of feces and flatus when
there is an obstruction of the large bowel or a
known lesion that will eventually cause
obstruction
 To permit healing of the bowel distal to the
colostomy opening since it diverts the fecal
contents from the affected area
 To provide a permanent means of bowel
evacuation when the rectum or anus are non
functional as a result of disease

8. Types of colostomy:
According to duration
 Permanent colostomy
 Temporary colostomy

9. According to stoma site

11. TYPE LOCATION CHARACTERISTICS
OF FECES
Ascending colostomy Right side of abdomen liquid form
Transverse colostomy upper abdomen,either
middle or towards
right
semisolid from
Descending/sigmoid
colostomy
lower left side of
abdomen
normal bowel
movement

12. Acc. to stoma number
 Loop colostomy
 End colostomy
 Double barrel colostomy

14. End colostomy/single barrel
colostomy

18. SINGLE
BARREL
DOUBLE
BARREL
LOOP

19. Pouching systems/Ostomy
appliances
 Individuals with colostomy has no control
over the output of stoma.
 Patients with ostomies must wear a pouching
system to collect the effluent from the stoma
and protect the skin from irritation.
 The pouching system must be completely
sealed to prevent leaking of the effluent

20.  The disposable pouching system consists of
a plastic bag and a flange/wafer (skin
barrier)that sit against the patient's skin
 The pouch has an open end to allow effluent
to be drained and may be closed using a
plastic clip or velcro strip
 Ostomy pouching systems vary based on the
type of stoma, stoma characteristics, stoma
location, patient abilities, skin folds and
patient preferences

22. Purposes of colostomy care
 To maintain integrity of stoma & peristomal
skin
 To prevent infection
 To promote general comfort and positive self
image
 To provide clean ostomy pouch for fecal
evacuation
 To reduce odour from overuse of old pouch

23. Colostomy care
 Provide privacy for the client
 Wash hands
 Place a waterproof pad under the client to
protect bed linen
 Empty the contents of the ostomy bag before
removing the bag. Note the colour, volume,
consistency and odour of the feces

24.  Gently remove the skin barrier and bag while
supporting the client's skin
 Place a gauze pad over the exposed stoma
to prevent soiling from leakage
 Wash the skin around stoma with warm water
and mild soap, and wash the stoma with clear
water
 Thoroughly rinse the area with water and pat
it dry

25.  Note the colour, moisture and protrusion of
the stoma and the condition of surrounding
skin
 Use a stoma measuring guide to cut the
flange or wafer into desired size
 Prepare skin and apply accessory products
like stomadhesive powder or paste. These
products are used to create a skin sealant to
adhere pouching system to the skin to
prevent leaking

26.  Apply the wafer and bag around the stoma.
Position the bag to hang in a dependent
position.
 Dispose of the soiled bag and appliance
properly

30. 1 2

34. Home care considerations
 Demonstrate how to clean the stoma to the
care giver
 Tell the client to expect effluent daily. It will
be watery initially, but will thicken within 2 to
4 weeks
 Expect excessive flatulence for 4 to 8 weeks

35.  Teach caregiver to watch for manifestations
of intestinal obstruction such as nausea or
vomiting, body temperature exceeding 1010F,
severe abdominal pain, distention, limited or
no output, decreased bowel sounds
 Pouching system should be changed every 4
to 7 days, depending on the patient and type
of pouch.

36.  Factors that affect pouching system include
sweating, high heat, moist or oily skin, and
physical exercises
 Avoid taking food which give rise to odourous
stool, eg.onion, garlic, meat
 Keep the peristomal skin near dry and apply
zinc oxide cream to prevent skin excoriation
 Frequent consultations with ostomy nurse

37.  Wound, Ostomy And Continence Nurses
Society
 United Ostomy Association of America
 Colostomy clinic & Ostomy nurse