Colostomy – Types and Nursing Care
*Introduction
Colostomy
Colostomy is a surgical procedure that allows intestinal contents to pass from bowel through opening in the skin on the ostomy site.
*Definition
A surgically created opening in the abdominal wall through which digested food passes
* TYPES
-Ascending
-Indications for ascending colostomy
-Transverse colostomy
-sigmoid colostomy
*Ascending colostomy
Semi liquid stool consistency increased fluid requirements needs appliances and skin Barrie’s cannot be irrigated
* Indications for ascending colostomy
Perforating diverticulitis in lower colon trauma inoperable tumors of colon rectum or pelvis, rectovagInal fistula
* Transverse colostomy
Semi Formed stool consistency possibly increased fluid requirement uncommon bowel regulations requires appliance and skin barrier cannot irrigate.
* Sigmoid colostomy
Formed stool consistency no Change in fluid requirements bowel regulations possible with irrigation and need for appliances for surgery
*PURPOSES
– To maintain integrity of stoma and persistent skin
-To prevent lesion ulceration
-To prevent from infection
– To promote general comfort and positive self image
-To provide clean colostomy pouch for fecal evacuation
– Reduce odour from over use of old pouch
*INDICATIONS
– Gangrenous sigmoid volvulus
– colorectal cancer
– penetrating abdominal injury
– Anorecatl cancer
– intussusception
-perinal injury
*CONTRAINDICATION
– Incipient cardiac failure and unstable angina
– Respiratory dysfunction
– Bleeding disorder
-kidney disease
-Skin infection
NURSING CARE OF COLOSTOMY
-Assessment of the stoma and provision of an appropriate poaching system
– providing the skin care on stom site
– protect the skin and contain drainage and order
– educating about the stom and care to the patient and family
-Teaching about the selecting appropriate pouch and emptying
– Teaching the complications about colostomy and pouch
– Emotional support to the patient
– counselling regarding to enhance the body image
-Demonstrating the colostomy irrigation
-Educating about the selecting appropriate food substance well balanced fluid intake
-Explain the important of follow up
– Routinely wash with warm water. Soap is used be sure to avoid ones with oils and rinse thoroughly
*COMPLICATIONS
– prolapse
-Retraction
-Fistula
-stenosis
-Herina