OSTOMY CARE

A Brief Overview

Catherine Walsh RN,BSN,CWOCN

Types of Ostomies

• Colostomy= large intestine

• Ileostomy = small intestine

• Ileal Conduit/Urostomy=urine

Appliances Available• One piece-Active Life=Cut-to-fit• Two piece=Natura wafer and

pouch, must match, cut-to-fit• Pediatric Pouches=urostomy and

drainable (colostomy), one piece• Preemie=Newborn pouches-up to

10lbs

Additional Ostomy Supplies

• Stomahesive Paste• Stomahesive barrier=4x4, 8x8• Colostomy clamps• Colostomy deodorant• Stoma dressing-Stomaseal-for non-

producing stomas• Skin prep (Coloplast),

Care

• Measure stoma with measuring guide. Cut wafer/base same size as stoma. If measuring guide not available, cut small then enlarge opening as needed. Never leave exposed skin to contact with effluent.

Care…continued

• Clean skin with water only• Do not use perineal wipes or bath

wipes around area for appliance when system is off pt

Care… Continued

• Paste is applied only to immediate area around stoma-like caulking a pipe

• Remove paper backing thick base first

• Apply to skin• Skin prep only where tape goes• Remove remaining paper.

Care…continued

• Fold pouch over clamp only once-more folds will break lock of clamp and leak

• Deodorant may be placed in pouch before clamping

• Urostomy pouches must be opened when attached to foley bag

Care…continued

• Empty ½ full• Do not let fill to top-will leak • Replace when leakage occurs• Ileostomy and Urostomy not

connected to foley bag will fill quickly-2 hours

• Empty/burp gas frequently-teach pt-can detach completely

Weartime:

• One piece pouch: 3-4 days or longer

• Two piece system: 5-7 days• Contact WOCN nurse if changing

more often