What is ostomy care?
Ostomy Care is as hygienic as possible with a stoma to keep it in optimal condition or coming, and inflammation and skin conditions can be prevented. A stoma is generally provided by the ostomy patient. If necessary, the stoma is provided by a nurse, or stoma care nurse.
Types
Are distinguished in medicine three types of stomas:
- Colostomy, a stoma of the colon (large intestine)
- Ileostomy, a stoma of the ileum (part of the small intestine)
- Urostomy, a stoma of urinary tract.
- Trachecanule, a stoma of the trachea.
Colostomy, Ileostomy and Urostomy
Collecting systems
To the exudates of the body coming out of the stoma comes to catch on, there is a collecting system for each stoma. This is a type of plastic bag (typically brown in color), but that pouch can sit confirmed in two ways to the body.
One-piece system
The retrieval of the one-piece system is a special round adhesive. In this layer is no opening, therefore it is the pouch as it were closed. Therefore, must first be measured with a special measuring map the diameter of the stoma. On the basis of this is in the adhesive layer with a special scissors (a pair of scissors which is bent at the tip) was cut an opening in adhesive layer, so that the stoma fit therethrough. It should be taken into account that the opening in terms of cross-section about 1 mm larger than the stoma is. This is necessary in order to prevent the adhesive layer pinch the blood supply to the stoma. In the worst case, would ensure necrosis can occur.
Two-piece system
This bag also has an adhesive layer, but which is not beforehand fixed to the ostomy bag. This adhesive layer is first attached to the skin without the pouch to it. This adhesive is a big hole. The hole in the adhesive layer is kept open by a plastic ring. At the pouch is a plastic ring. The ring of the pouch and the adhesive layer are right on each other, whereby the pouch, as it were, is snap-fit.
Shelter material
There are two types of ostomy bags for colon, ileo and urostomy's:
- Open system; the stoma bag has an ability to open the bottom of the pouch, so that when emptying the stoma bag need not to be taken off and can be reused. The disadvantage is that after emptying feces is left in the stoma bag.
- Closed system; This system has no ability to open. The stoma pouch needs to be replaced very regularly. The ostomy bag can not be re-used in principle. Some stoma patients are willing to reuse the bags and flush them out. The risk here is that due to lack of hygienic working there is an inflammation of the stoma could occur.
Tracheostomy tube
A tracheastoma consists of three parts: an outer cannula and an inner cannula carrier. The last two can loosened during grooming and cleaning. The outer cannula may not be removed. This holds namely tracheastoma open. If removed, the stoma shooting close and the patient can not breathe. Experienced workers can usually reinsertion and outer cannula else needs professional help as soon as possible to be involved.
Care
Colostomy, Ileostomy and Urostomy
In the care of the stoma should take into account a number of points:
- If the stoma bag is removed and the stoma is in direct contact with the outside air, it is advisable to lay a wet gauze to the stoma. As a result, it protects the stoma and is counteracted that faeces come out of the opening
- Excrement may not come into contact with the skin around the stoma around
- In the adhesive no folds as this may cause skin irritation or leakage
- If necessary, can be applied to, or odor filters in the bag
- The skin around the stoma with warm water. Due to wash the stoma can prevent dirt from entering.
Tracheostomy tube
A distinction must be made between 'tracheostomy' and a 'tracheotomy. In a tracheostomy operative anatomy in the neck dramatically changed (total laryngectomy) and the trachea terminally ending attached to the neck. It concerns an irreversible (tracheotomy) stoma. The shape of this stoma is usually not dependent on the presence of a cannula. There may be other reasons to use a cannula into the tracheostoma. A tracheostomy can shrink and therefore get most people with a tracheostomy advised to wear a single-walled cannula with prescribed regularity. Wearing filter the tracheostomy is recommended. Filters are in order all shapes and sizes in the pharmaceutical industry. In a tracheotomy is the presence of a cannula is of great importance in order to maintain the shape and function of the opening to the trachea. The cannula in a tracheotomy is therefore always composed double the inner cannula can be removed for cleaning and the outer cannula must always remain in place (unless the caregiver or patient himself has been authorized and the doctor's instructions on removing and Replacing it) .very should be checked regularly for the fixation of the outer cannula (with a strap around the neck or by sutures through the skin) is absolutely sure. The inner cannula should be cleaned with a prescribed frequency in order to avoid blocking of the inner cannula with mucus. Regular spraying in the cannula with saline 0.9% is recommended as mucus, coughed must be tough and effort to cough from the cannula. Wearing a filter on the cannula is advisable.
Observing
During the treatment, the following observation points of interest:
- leakage
- color of the stoma (necrosis or any inflammation)
- bleeding
- correct positioning of the stoma; There may be a part of the intestine to the outside?
- swelling of the stoma
- filling of the pouch
- feces are observed on the odor, color and quantity
- skin irritation.