Stomas require proper wound care to avoid infection and other complications.
Many people think of injury recovery when they hear about wound care, but proper attention to a wound is necessary in a variety of situations, such as surgeries. Stomas are much more common than many might think – according to the United Ostomy Associations of America nearly 1 million Americans are living with stomas. Learn more about these surgical openings and how to properly care for them:
What is a stoma?
A stoma is an opening in the body purposefully created during a surgical procedure called an ostomy, and it requires continuous wound care to ensure it does not become infected. As the National Institutes of Health explains, the purpose of the stoma is to create a pathway to the inside of the body so certain diseases of the organs can be treated. They generally target either the urinary or digestive system.
These openings can be either permanent or temporary depending on the needs of the patient. Permanent openings are utilized when an organ must be removed from the body completely, while temporary ones are applied when the organ simply needs time to heal. Each type of stoma serves a specific purpose according to the different kinds of ostomies, the most common of which include:
- Ileostomy: The stoma leads to the bottom of the small intestine, bypassing the anus, rectum and colon.
- Colostomy: The colon attaches to the stoma in order to bypass the rectum and anus.
- Urostomy: The stoma attaches to the tubes that transport urine to the bladder.
Potential complications after an ostomy
Stoma complications are unfortunately quite common. One of the reasons for this is that the stoma is insensitive to pain as it has no sensory nerve endings, so patients may not be aware of irritation and soreness that can be a sign of wound infection. Such complications often occur immediately following the surgery or within 30 days of the operation, but they can happen at any time, making ongoing assessment by a clinician on a regular basis essential. Among the most common stoma issues include:
Ostomy surgeries affect the abdominal walls, increasing the risk of a hernia after the operation. Hernias occur when the muscles in the abdomen are torn or detached, allowing parts of the intestines to protrude through the openings. The skin at the site of the stoma may bulge outward and jut away from the body. Surgery is often the treatment plan for hernias, but they tend to continue to be persistent even after intervention. These bulges can also make it difficult to apply wound dressings and keep stoma pouches in place.
These openings in the body naturally protrude slightly outward. However, when it retracts – becomes flush with or below the skin – it can cause problems with leakage. Retracted stomas are much more susceptible to excessive exudate as the opening outputs its fluids directly to the skin. This can cause skin irritation, compromise the adhesive quality of pouch barriers and require increased changing of wound dressings.
Bowel fluids, pouches and adhesives cause a lot of irritation around the stoma and require careful cleaning to keep the skin dry and free of bacteria. Otherwise, a wound infection can occur at the site.
Most commonly found with ileostomies, stoma blockages are obstructions caused by food and bowel contents. The signs of blockage may include cramps and stoppage of stoma output as well as swelling. It’s generally cured easily by drinking and bathing in warm water, which can relax the muscles to allow food to pass.