OSTOMY CARE A Brief Overview Catherine Walsh RN,BSN,CWOCN
Types of Ostomies • Colostomy= large intestine • Ileostomy = small intestine • Ileal Conduit/Urostomy=urine
Appliances Available • One piece-Active Life=Cut-to-fit • Two piece=Natura wafer and pouch, must match, cut-to-fit • Pediatric Pouches=urostomy and drainable (colostomy), one piece • Preemie=Newborn pouches-up to 10lbs
Additional Ostomy Supplies • Stomahesive Paste • Stomahesive barrier=4x4, 8x8 • Colostomy clamps • Colostomy deodorant • Stoma dressing-Stomaseal-for non-producing stomas • Skin prep (Coloplast),
Care • Measure stoma with measuring guide. Cut wafer/base same size as stoma. If measuring guide not available, cut small then enlarge opening as needed. Never leave exposed skin to contact with effluent.
Care…continued • Clean skin with water only • Do not use perineal wipes or bath wipes around area for appliance when system is off pt
Care… Continued • Paste is applied only to immediate area around stoma-like caulking a pipe • Remove paper backing thick base first • Apply to skin • Skin prep only where tape goes • Remove remaining paper.
Care…continued • Fold pouch over clamp only once-more folds will break lock of clamp and leak • Deodorant may be placed in pouch before clamping • Urostomy pouches must be opened when attached to foley bag
Care…continued • Empty ½ full • Do not let fill to top-will leak • Replace when leakage occurs • Ileostomy and Urostomy not connected to foley bag will fill quickly-2 hours • Empty/burp gas frequently-teach pt-can detach completely
Weartime: • One piece pouch: 3-4 days or longer • Two piece system: 5-7 days • Contact WOCN nurse if changing more often