Caring patients with colostomy

1. COLOSTOMY CARE
Alexhandra Nicole S. Miaral, RN

2. • Colostomy – surgical procedure in which the
colon is shortened to remove a damaged part and
the cut end diverted to an opening in the
abdominal wall to create a stoma.
• Colostomy Care – the pouch, stoma, and skin
surrounding the stoma require care and
maintenance
*Stoma - an opening in the skin where a pouch is
attached for collecting feces.

3. Purpose
To maintain integrity of stoma and peristomal
skin.
To prevent infection.
To promote general comfort and positive self-
image.
To provide clean ostomy pouch for fecal
evacuation.
To reduce odor from overuse of old pouch.

4. Indication of Colostomy
• Birth defect
• Inflammatory bowel disease.
• Injury to the colon or rectum
• Partial or complete intestinal or bowel
blockage
• Rectal or colon cancer
• Wounds or fistulas in the perineum

6. Ascending
Colostomy
Transverse
Colostomy
Descending
Colostomy
Sigmoid
Colostomy
usually
located in the
low to middle
right side of
the abdomen
usually
located in the
center of the
abdomen
above the
navel
typically
located on the
lower left-
hand side of
the abdomen
located in the
lower left-
hand side of
the abdomen
output is
often liquid to
semiliquid,
and gas is
common
output often
is liquid to
pasty, and gas
is common
output may
be pasty to a
formed
consistency,
and gas is
common
output is
usually pasty
to a formed
consistency,
and gas is
common

7. Assessment - Stoma
• Stoma color
Normal – pink/red/warm to touch
Abnormal – black/dusky/pale
• Skin
Normal : post – op period the stoma can be quite swollen;
may reduce in size for about 6 wks after surgery
Abnormal – any sudden or unexplained swelling of the
stoma
• Bleeding Stoma
Normal – a slight smear of blood on the wipe when
washing or drying the stoma
Abnormal – excessive bleeding when cleaning the
stoma/blood in the pouch/bleeding from inside

8. Assessment
• Size
Round – measure using the stoma measuring guide
Oval – measure length and width
• Color
Red – adequate blood supply
Pale – low hgb
Dark red/purplish stint – indicates bruising
Grey to black – no blood supply
Other – appearance healthy – shiny and moist

9. Assessment - Peristomal Skin
• Color
Healthy – no difference from adjacent skin surface
Erythema – red
Bruised – purplish to yellowish color
• Integrity
Intact – no breakdown in skin
Erosion – superficial skin damage
Rash – an outbreak of lesions on the skin
Ulceration – a wound through the dermis layer
Other – turgor normal (soft, good elasticity)

10. Pre-procedure preparation
• Detailed hx taken down; current complaint, hx
of presenting illness, past medical hx (co-
morbidities); surgical hx; social and
environment hx
• Medications and allergies documented