COLOSTOMY and ILEOSTOMY CARE
DEFINITION:
An Ostomy is a surgically constructed opening of an internal organ on the surface of the body.
There are many types of ostomies:
Gastrostomy: this is an opening through the abdominal wall into the stomach
Jejunostomy: this is an opening through the abdominal wall into the jejunum.
Ileostomy: this is an opening into the ileum (small bowels).
Colostomy: this is an opening into the colon (large bowel).
Ureterostomy: this is an opening into the ureter.
Tracheostomy: a surgical procedure to create an opening through the neck into the trachea.
Gastrostomies and jejunostomies are generally performed to provide an alternate feeding route.
Bowel and urinary ostomies is to divert and drain fecal or urinary material.
PURPOSES for COLOSTOMY and ILEOSTOMY CARE
1. To collect stool to facilitate the patient’s return to a productive lifestyle.
2. To collect effluent for accurate assessment of output in the hospital
3. To protect the peristomal skin from erythema, excoriation and infection
4. To protect the patient’s clothing.
5. To maintain comfort and hygiene of the patient.
EQUIPMENT:
1. Colostomy bag or pouch of appropriate size
2. Toilet tissue
3. Soft wash cloths, rags, gauze swabs or cotton balls
4. Bath towel and blanket
5. Clean linens
6. Protector (for bed)
7. Receptacle for soiled articles
8. Bowl or Basin with warm boiled water
9. Scissors
10. Mild soap (optional)
11. Face masks
12. Unsterile glove
13. Dark marking pen
14. Bed pan with cover
PROCEDURE:
1. Explain procedure to the patient and obtain consent.
2. Ensure privacy. Wash hands.
3. Prepare clean pouch or bag (cut central opening to fit neatly around stoma if required). Cut
pouch to pattern making sure opening is large enough (at least 1/8), to encircle stoma
without pushing on edges.
4. Place blanket over patient, protector under client and position in high or semi fowler.
5. Wash hands and don gloves
6. Carefully peel off soiled pouch, starting from the top, avoid dragging the skin.
7. Discard the used pouch in receptacle.
8. Wipe around the stoma with dry tissue.
9. Wash gentle the stoma and surrounding area with warm water.
10. Pat dry area with towel.
11. Observe skin and stoma for changes in size, ulceration, and color (stoma should be a beefy
red).
12. If using barrier cream, massage into skin until completely absorbed, wipe away any excess.
13. Peel off backing paper, center the hole over the stoma and press firmly and evenly ensuring
that it is smooth and unwrinkled.
14. Close and secure end of pouch with tail closure
15. Remove bath blankets
16. Remove gloves and perform hand hygiene
17. Position patient for comfort.
18. Clean and discard supplies as necessary
19. Measure contents
20. Report and document findings
SPECIAL POINTS:
1. The stoma has no nerve supply so it is insensitive to pain, it is therefore necessary to avoid
accidental injury.
2. One-piece adhesive pouch should be changed when the contents reach the halfway mark or
when patient feels uncomfortable.
3. If a two-piece system is used the flange is left in place for 3 or 4 days. The drainage bag
changed whenever convenient.
4. Avoid unnecessary changing of pouch to prevent sore skin around stoma.
5. Ensure that the correct size pouch is used so as to prevent leakage of faeces onto the skin
