A stoma is a surgical opening created as an alternative access route for the body to drain excess fluids and waste. These openings are created in the windpipe, a tracheotomy, the voice box, a laryngostoma, near the stomach and the small intestine, an ileostomy, and the large intestine, a colostomy. The stoma and surrounding tissue require special care to prevent infection.
- Skill level:
- Moderately Easy
Things you need
- Sterile gauze
- Sterile saline solution
- Cotton swab
Wash the hands thoroughly for 10 to 15 minutes with soap and warm water. Pay special attention to areas that harbour bacteria, such as under the nails and in between the fingers.
Remove the old dressing surrounding the stoma site. The gauze dressing is framed around a plastic ring that protrudes from the skin. Use caution when removing the dressing around pelvic and abdominal stomas and do not pull the attached drainage tubing. Slight bleeding may occur because of a blood vessel rupture around the stoma site. Place sterile gauze and apply pressure until the bleeding subsides.
Inspect the skin around the stoma. Look for warm, pink skin that is free from redness, swelling and yellow drainage. If infection occurs, report it immediately to a health care provider to prevent the infection from proliferating throughout the system. Check for signs of skin damage due to a securing mechanism, such as a tie for a tracheotomy. Note abrasions and rashes, which are common complications, caused by rubbing of the securing mechanism.
Wet a washcloth with warm water and apply unscented, mild soap. Wipe the soap around the ring of the stoma and the surrounding areas in a circular motion to remove bacteria and dirt. Avoid applying soap directly into the stoma opening. Wet another washcloth with just warm water and wipe the same area to remove the soap. Make sure all the soap has been removed.
Apply clean stoma dressing using sterile gauze. Cut a straight line from one side of the gauze to the centre, so it can be easily slipped around the stoma.
Dispose of used gauze and wash hands thoroughly with soap and warm water.
Tips and warnings
- For patients with a tracheotomy and a laryngostoma crust may develop around the stoma due to dried mucus. Remove these crusts with a cotton swab dipped in sterile saline solution. Instruct the patient to hold their breath while cleaning to avoid inhaling the crust into the tube.
- To prevent infection, drain colostomy and ileostomy stoma sites when connected bags are one-third full. Empty the fluid and waste carefully into the toilet. Clean reusable bags with saline solution and toss disposable ones into biohazard trash bags.
- Keep track of the amount of output in colostomy or ileostomy drainage bags to ensure the stoma site is draining properly and remains unobstructed.
- If excess bleeding or secretions are found at the stoma site, immediately contact a health care provider.
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