Improper postoperative care of ostomy is prone to various ostomy complications. It is undoubtedly the skin problem that bothers most of my friends. Redness, itching, and even ulceration and swelling of the skin around the stoma will increase the difficulty of care. Today I will share with you a case I saw in the stoma customer group two days ago.
The patient's self-report: the skin around the stoma is tingling, and the skin feels very painful.
Conclusion: From the picture above, it can be seen that rashes or redness, broken skin, small spots, and even pustules on the hair follicles around the stoma are stoma folliculitis. As the name suggests, the hair follicles cause purulent inflammation. It has something to do with body hair.
What is the reason for it?
Usually due to hair follicle damage, caused by bacterial infection. Staphylococcus aureus, a common bacterial species, generally appears as bean-like pustules or red protrusions. It is also related to stuffy heat, sweating, pressure, and excessive body hair in patients. It may also be that the method of removing the stoma chassis is incorrect.
deal with folliculitis in the skin around the stoma ?
The folliculitis in the above picture is mainly caused by tearing off and withdrawing the hair, or it may also be stimulated by stool. In this case, you need to pay attention to cleanliness and sanitation, and the interval between changing the chassis should not be too long. When there is hair around the stoma, you need to cut it flat with scissors, and do not use a razor to remove it, so as not to damage the hair follicles. When removing the stoma disc, press the skin with one hand, and slowly tear off the stoma disc with the other hand. If the disc is too tight and difficult to remove, use glue remover to remove it, and wash the skin around the stoma with a weak acid bath For mild folliculitis, erythromycin ointment can be used to alleviate it. However, when pustules appear in the hair follicles, you should suspect whether there is fungal or Staphylococcus aureus infection, and use it according to the doctor's advice for the bacteria species. Anti-inflammatory powder medicine.
"Why are there frequent skin problems around the stoma?"
1. The size of the stoma is not static. There will be edema in the early stage after surgery, and the size of the stoma may change in the later stage. Therefore, it is necessary to measure and cut the appropriate center hole before changing the stoma bag every time. It is recommended to cut it every time.
2. When cutting the center hole of the chassis, the hole diameter should be about 2mm larger than the root of the stoma nipple. If it is too large, it may cause fecal water dermatitis due to skin exposure and contact with feces, and if it is too small, it may cause intestinal mucosal friction and bleeding.
3. When replacing the ostomy bag, remove the chassis gently and slowly, avoid violent removal, and avoid skin irritation. A stoma disc adhesive release agent should also be used to help remove the disc easily.
4. The ostomy bag does not need to be replaced every day. Generally, the one-piece ostomy bag can be replaced every 2-3 days, and the two-piece ostomy bag can be replaced every 3-5 days. However, the specific replacement time varies from person to person. Leaks must be replaced immediately.
5. If there are depressions, scars or folds in the skin around the stoma, and the chassis cannot be closely adhered to the skin, you can use anti-leakage cream to fill up the depression or scars, and then attach the stoma bag so that the stoma bag is tightly and evenly attached to the skin.
6. If the ostomy nipple is flush with or lower than the abdominal skin, you should choose a convex chassis + belt.
7. Friends with thicker hair need to shave off their body hair before sticking the ostomy bag.
For more information on Innomed®ostomy attachment, 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: November 18 , 2022