COLOSTOMY CARE

INTRODUCTION

DEFINITION
A colostomy is a surgical
procedure in which an
opening (stoma) is formed
by drawing the healthy
end of the large
intestine or colon through
an incision in the anterior
abdominal wall and
suturing it into place.

TYPES OF COLOSTOMY
ACCORDING TO DURATION

Permanent Colostomy
Temporary Colostomy

ACCORDING TO STOMA SITE

Ascending Colostomy
Transverse Colostomy
Descending Colostomy

ACCORDING TO STOMA NUMBER &

TYPE
Single Barrel Colostomy
Double Barrel Colostomy
Loop Colostomy

INDICATION FOR
COLOSTOMY
1.Colon Cancer
2.Hirschprungs Disease
3.Ulcerative Colitis
4.Polyps in Intestine

PURPOSE OF COLOSTOMY CARE

1.Skin protection & care
2.Receptacle for drainage
3.Patient acceptance & self care

ARTICLES REQUIRED

A clean tray
containing

Mackintosh with
draw sheet
Kidney tray/paper
bag
Pair of clean gloves
Colostomy bag
NS/Basin with warm
tap water
Gauze pieces

Gauze pad/tissue
paper
Skin barrier
Stoma measuring
guide
Pen or pencils &
scissors
Bed pan

PROCEDURE
PROCEDURE

1. Gather equipment.
2. Encourage clients to
look at the stoma.
3. Explain the
procedure to the
patient.
4. Provide privacy.
5. Perform hand
hygiene & wear
gloves.

RATIONALE
1. Ensure that everything
is there to render the
care.
2. It encourages
participation in the
stoma care.
3. To gain confidence of
the patient.
4. For smooth performance
of procedure.
5. To prevent infection.

PROCEDURE

Spread mackintosh &

draw sheet.
Remove used pouch &
skin barrier gently by
pushing the skin away
from the barrier.
Remove clamp and
empty the content into
bed pan. Rinse the
pouch with tepid
water/NS.
Discard the disposable
pouch in paper bag.

RATIONALE

To protect linen.
Reduces trauma,
jerking, irritates skin
& can cause tear.
To minimize the
odour & growth of
microbes.

PROCEDURE
Observe stoma for
colour, swelling, trauma
& healing. Stoma should
be moist & pink.
Cover the stoma with a
gauze piece.
Clean peristomal region
gently with warm tap
water using gauze pad.
Don't scrub the skin,
dry by patting the skin.
Remove gauze & clean
stoma with gauze

RATIONALE
To find out
complications.
To prevent the faecal
matter from contacting
with skin.
Stoma surface is highly
vascular. Skin barrier
does not adhere to wet
skin.
-do-

PROCEDURE
Measure the stoma
using measuring guide.
Trace same circle
behind the skin barrier,
using scissors, cut an
opening 1/16 to 1/8
inch larger than stoma
before removing the
wrapper over adhesive
part.
Put skin barrier & pouch
over the stoma, &
gently press on to the
skin, for 1-2 min.

RATIONALE

Ensure accuracy in
determining correct
pouch size needed.
-do To prevent irritation to
skin.

PROCEDURE

Use the pouch if it is drainable using a clamp or

clip.
Remove gloves and wash hands.
Make the patient comfortable.
Clean the area and replace all articles.

DOCUMENTATION
Record the procedure with following
details:
Date/Time
Amount
Colour
Consistency of faecal matter
Sign of any infection

COMPLICATION

Necrosis of Stoma
Retraction of Stoma
Prolapsed of stoma
Stenosis or Narrowing
Parastomal hernia

SUMMARIZATION