Sharing a case of stoma complications that I saw in the client group a few days ago, Ms. Bai found that the stoma was flushed and had small bumps around the stoma on Tuesday morning, so she came to consult our stoma nurse,
The condition of Ms. Bai's stoma is shown in the picture below.
evaluate Ms. Bai's stoma and surrounding conditions :
①The shape of the stoma is intact, and it should not be easy to cause leakage, so it may be caused by the too large chassis of the stoma.
②There are small red bumps around the stoma, typical of fecal water dermatitis.
Fecal water dermatitis :
Fecal dermatitis refers to the erosion of the skin around the stoma caused by irritation of fecal water. Due to the specificity of ileostomy excretions, the possibility of postoperative fecal water dermatitis was as high as 26.9%.
Causes of fecal water dermatitis :
①The position of the stoma is poor.
②The ileostomy did not form a proper protruding papilla.
③ Improper stoma care.
④ leakage caused by skin folds.
Treatment of fecal water dermatitis :
Use warm water or normal saline to clean the stoma and surrounding skin to minimize irritation to the skin. After cleaning, use the triple protection of stoma powder, skin protection film, and leak-proof cream.
Nursing points for fecal water dermatitis :
cutting of the stoma tray is too large, it indirectly affects the fit of the stoma tray and the skin, which may easily lead to fecal dermatitis. It should be re-measured in time and recorded.
The micro-convex chassis is selected for the product, and the belt is used to pressurize the skin around the stoma so that the stoma discharge port is higher than the skin surface, which is conducive to a better collection of excrement and reduces the occurrence of leakage and skin damage.
The stoma nurse practitioners at Longterm Medical recommend the following steps of care :
①After gently removing the chassis, rinse the skin around the stoma with normal saline to keep the skin around the stoma dry and clean.
appropriate amount of Longterm Medical Skin Protective Powder, evenly apply to the skin around the stoma, and sweep away the floating powder after 3 to 5 minutes of absorption.
③Use Longterm Medical Skin Protective Spray and let it dry.
④Use the Longterm Medical Ostomy Measure Card to re-measure the stoma size, leaving 1-2mm at the edge. The cutting chassis must be accurately cut according to the shape of the stoma and the size of the root. Too large or too small will damage the stoma. Before cutting, measure the stoma, up and down diameter, left and right diameter, mark it on the backing of the chassis and use a pen to connect the 4 points to get the size of the stoma. You can leave the backing every time, and you can cut it to the same size next time. If the exposed skin is too large, it will be easily corroded by stool, and if it is too small, it will compress the stoma mucosa and cause necrosis.
⑤ Use the Longterm medical Skin Protective Ring to closely surround the root of the stoma to ensure that there is no gap between the skin and the intestinal mucosa.
⑥On the product, you can choose a slightly convex chassis and belt reinforcement.
So how to prevent the occurrence of fecal dermatitis?
①Choose suitable stoma products and wear them correctly.
②Measure the size of the stoma before changing the chassis each time.
③ Discharge the contents of the ostomy bag in time.
④ Take good care of the skin around the stoma.
⑤ Master the frequency of ostomy bag replacement .
⑥ Pay attention to diet, ensure balanced nutrition, and avoid obvious weight gain or loss in the short term.
Efforts to improve the quality of life for patients with enterostomy have always been our pursuit!
The nursing of stoma and the rehabilitation of complications are important links to improve the quality of life of patients with a stoma. Early prevention, timely detection, and implementation of effective nursing care are needed to reduce the incidence of intestinal stoma complications, thereby reducing the risk of complications. chance of complications.
For more information on Innomed® ostomy pouch, 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 8, 2022