Stoma retraction case sharing.

In the patient group, I saw an uncle asking for help. The uncle is 72 years old this year. Due to acute intestinal obstruction and peritonitis, he underwent a left hemicolectomy and ileostomy in a local hospital. Unbearable, can't sleep.

After hospital inspection, it was found that in the 1/3 of the line connecting the umbilicus and the right anterior superior iliac spine, the stoma mucosa was ruddy in color, and the stoma was retracted. The skin around the stoma also had an obvious skin erosion area, and there was a raised area next to the stoma. The surrounding normal skin is about 1.5 cm in diameter, and the skin erosion area is 6 cm in diameter, with a radial network of uneven red, yellow and green (50% red, 25% green, 25% yellow) with a small amount of blood in the stoma center. Fluid oozing, pain sensitivity.

I learned that the patient has four children, who are not around, and that his wife cannot take care of and help the patient due to visual impairment. Patients often dare not eat or do normal activities for fear of exacerbating the condition due to excessive fecal flow and are mainly bedridden. Due to unbearable pain and inability to sleep all night, she was emotionally irritable, often felt lonely and helpless, had suicidal thoughts, and held a pessimistic and negative attitude towards treatment. Under health guidance and psychological care, the uncle's condition has gradually improved, and his mentality has become calmer than before. Let me tell you about stoma retraction and how to deal with it. Let's take a look at it with me.

What is stoma retraction?

Early complications after ostomy and their incidence account for 1.5%-10% of colostomy complications. There is often excretory flow around the retracted stoma, and many retracted stoma are accompanied by depression around the stoma. This type of stoma is relatively common, and it will be accompanied by excretory flow around the stoma, which can also cause stoma. Occurrence of complications of perioral dermatitis. Seriously affect the quality of life and physical health of patients.

The selection and sticking of the ostomy bag and the treatment of the skin around the stoma:

Nursing experience:

There are a variety of products that can help make a good seal between the surface of your stoma and your skin.

You might want to try Longterm Medical's skin protective ring , which is a stoma seal designed to shape and provide extra safety for pouches that fit over uneven, cracked, or retracted skin. The Anti-leakage strip easily shapes to your needs, and the Ostomy belt helps keep pressure on the stoma. Skin protective paste allows the stoma to fill the gap at will. Skin protective power and skin protective spray keep the skin surface around the stoma drier and more comfortable.

①Cleaning: Gently scrub the stoma and surrounding skin with warm water gauze to remove excrement, carefully scrub the concave skin and residual feces on the ulcer with a cotton swab dipped in warm water, and then use a 1:3 white vinegar saline gauze to scrub and partially wet Apply three mini, and then use a syringe to aspirate the normal saline to rinse the area of skin inflammation around the stoma for 5 minutes, and dry it with sterile dry gauze.

②Skin protection: Apply stoma skin care powder and spray skin protective film evenly on the skin of the inflamed area several times, especially the sunken and concave areas of the skin should be filled with anti-leakage cream, which is easy to stick to the pocket, prevent side leakage and protect the skin.

③ Patch pocket: Choose a 1-pack clear ostomy bag to trim the opening of the chassis according to the shape of the stoma, peel off the backing, stick the pocket from the bottom up, and press again from the inside out of the opening for a moment, and let the patient take the standing position with a moistened small A cotton swab is inserted into the bag from the opening of the stoma tray, and the leak-proof paste is smoothed again at the opening of the stoma tray to prevent leakage from the pores of the stoma tray.

④ Nursing steps: First, observe the size of the stoma, and cut it a little bit until the size is appropriate. Then wipe around the stoma with normal saline, apply a thin layer of stoma powder, and spray with a skin protectant.

It should be noted that in order to achieve the effect of crawling the skin, there is a thin layer of stoma powder on the broken skin, and the other places are wiped clean. White powder, at this time, you need to get closer and spray the following until the white powder is no longer visible, and then let it dry before proceeding to the next step. Then use the stoma leak-proof ring. The leak-proof ring is directly attached to the chassis, but the distance from the notch should be left about 1mm. Stick this part inside the chassis, and the effect may be better. The uneven skin can also be filled with leak-proof cream. Note that the convex chassis should also be used with the belt, and the size should be adjusted appropriately.

Tips: Be sure to observe the state of the excrement and choose a chassis that suits you

Tips: Be bold and careful, don't be afraid; I believe your operations will become more and more proficient!

I wish everyone a speedy recovery!!

If you have a leak, have your ostomy nurse review it to check for other causes of the problem. Once you are concerned, a professional stoma care nurse should evaluate your retracted stoma.

For more information on Innomed® Ostomy bag, 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: August 12, 2022