A stoma, an opening in the body that used for bowel or urine elimination, usually needs a lot of care. The skin around the stoma must be kept clean and free of infection. Care also requires the removal or drainage of the appliance that is attached to the opening. The area around the stoma must be cleaned, a new appliance must be placed over it, and clipped down, if needed. Caring for a stoma site usually also requires the disposal of any waste that is in the appliance.
The three basic types of stomas are the colostomy, ileostomy, and urostomy. A colostomy opens up to the large intestine, while an ileostomy connects to the small intestine. Both the colostomy and ileostomy are used to remove bowel waste. A urostomy is an opening to the urinary tract that is used to remove urine from the body. The location of these sites is often an important consideration for stoma care.
Stomas are generally located in the lower sections of the abdomen. The exact locations may vary, though, and may affect stoma care. This is because a person who is caring for his own stoma site must be able to see the opening if he is going to care for it properly. He must also be able to reach it to take care of it, so if he is restricted to a wheelchair or is overweight, he may need another person to provide care.
When caring for a stoma site, a person must always be on the lookout for infections, irritations, and symptoms of other problems, like diseases or injuries. A nurse, home health provider, or doctor will usually explain what to look for before the patient is allowed to be independent. Any problems should be reported and taken care of by a medical professional.
Cleaning around the stoma must be done each time the person drains or removes the appliance that is attached to it. Generally, non-perfumed soap is used to prevent skin irritation. Oils and perfumes in soaps can also keep a stoma bag from adhering correctly. All waste around the stoma site will need to be removed with a soft tissue or cloth.
After the stoma site is cleaned and a person has checked for signs of irritations or infections, he can then place a new appliance over the opening. Typically, holding the appliance against the skin for a few minutes will help form an adhesion to the skin. This prevents leaks and keeps the appliance in place over the opening. Any waste that was in the stoma appliance can be flushed down the toilet. The bag or appliance will then usually be placed in a waste removal bag and discarded.