Life with a stoma

Stoma care

• To avoid spillage on clothing and to collect used equipment, the waste bag is attached to the waistband.
• The stoma disc is loosened with a moist compress and carefully removed.
• The skin and stoma are carefully washed with a lukewarm compress before it is dried/air dried/blown dry. It is the normal for the the stoma to bleed when touched.
• Red, dry skin can be moistened with barrier cream in a thin layer. The cream should absorb into the skin for a few minutes before excess cream is dried away such that the disc will adhere to the skin.
• The stoma template is cut out of cardboard or colorless, stiff plastic to the size of the stoma . A caliper can be used for measurement .
• The stoma template is placed on the back of the new adherence disc and traced before adherence disc is cut and threaded over the stoma. Check that it sits properly on the skin.
• A one component bandage consists of a complete bag with adhesive surface . The one component closed back is changed after every bag change which is usually 2-3 times a day. A one component reusable bag is changed daily or every other day.
• A two component bandage consists of s skin disc and bag in two parts . The bag is threaded over the stoma and attached to the disc. The disc is usually changed 2-3 times per week. The closed, reusable bag is changed like a one component bandage and changed as needed.

For a small intestine stoma, it is recommended to change the bag before breakfast because the bowel content comes almost immediately after the patient has eaten.

Irrigation

Irrigation is an alternative to a skin disc and back and is used in patients with a colostomy. The advantage of irrigating is that in between, there is little feces and bowel gases and the risk for odor and sound is less. Irrigation is time consuming (about one hour) which should be done every other day. Most patients therefore recommend using stoma bags.

• A water holder with water regulation and an irrigation bag is required.
• The colon is emptied by regular insertion of water enema.
• The bowel is emptied every other day by using around 800-900 ml of body temperature spring water set via the stoma and in the bowel.
• The stoma is bandaged in the end with a mini bag or Mini Cap with air filter with little/no space for bowel content.
• At the Radium Hospital, stoma nurses are reponsible for training the patients in the technique.