Stoma skin care is an important issue for colostomy patients in order to avoid possible complications. Not only will proper maintenance help fight off rashes, irritation and infection, but it will also ensure that your ostomy appliances will function as intended. Any type of rash or skin condition can interfere with how skin barriers and appliances adhere to the skin around the stoma. This can cause leaks which in turn can cause the underlying skin condition to become worse. Prevention is the best course of action to keep the peristomal skin (the skin around the stoma) healthy and free from problems. New colostomy patients should know the basics of how to care for the area around the stoma as well as when to seek the help of their nurse or doctor if skin problems arise.
Preventing a skin problem is usually a lot easier than treating one, and one of the best ways to keep the skin healthy is to keep it clean. Fecal matter will likely come into contact with the skin at some point as leaks are almost inevitable and will take place from time to time. Not allowing the peristomal skin to stay covered with waste material for too long and promptly cleansing if leaks do occur can go a long way towards preventing problems.
Regular washing of the skin around the stoma is very important, but if done incorrectly can cause complications on its own. Basic warm water is all that you need. Whenever you remove the skin barrier, you can gently use a cloth with warm water to clean the area around the stoma. Some people prefer to remove everything and rinse themselves when they take a shower. You do not have to clean the stoma as it is already naturally protected, just gently cleansing the skin around the stoma regularly is where the focus should be. The key word being “gently”. Harsh and overdone scouring of the area around the stoma can strip the skin of defensive layers and oils and cause the skin to become dryed out and irritated. This in turn, can be problematic with trying to get skin barriers and wafers to adhere properly. Soap can be used, but it should preferably be oil-free and it should not leave any type of sticky film on the skin. If you use special wipes to remove adhesive residue from skin barriers make sure to rinse afterwards with warm water. Cleaning your skin is crucial, you just want to avoid over-doing it. Simply pat the area dry after cleansing before applying your skin barrier or colostomy bag.
Besides regular cleaning of the peristomal skin, the other key factor to avoiding skin problems is ensuring that your colostomy pouch fits properly around the stoma. If you can see any skin after the skin barrier is applied chances are the hole was cut too big. For new patients, measuring your stoma and cutting the proper hole in your barriers is important as the stoma will tend to shrink in the weeks after the colostomy surgery. The skin barrier or colostomy bag, depending on what type of colostomy pouching system being used, should fit close around the stoma but it should not be too tight. Having a correctly fitted appliance is the first defense for the skin from contact with waste material due to any possible leaks.
There are numerous products on the market designed to help colostomy patients protect the peristomal skin. From pastes and powders to wipes and strips, the number of skin care products continue to grow. While not exactly necessary, some patients that experience skin problems find these products extremely helpful.
Specialty powders can help protect the skin and absorb moisture. If using these kind of powders you should spread it evenly around the stoma and be sure to remove any excess to assure a good skin barrier seal.
Pastes are used as a sort of caulking around the stoma. These are used to fill in any gaps between the stoma and the skin barrier or pouching system being used. These usually contain some form of alcohol so it should be used with caution if any broken skin is present to avoid stinging and discomfort.
Protective wipes can be used to wipe down the skin around the stoma. These leave a film on the skin that guards the skin against contact in case of a leak and it can also make the removal of skin wafers a simpler task. These may also contain alcohol and may sting broken or irritated skin.
When to Contact Your Doctor
If any sores, irritation and redness that spreads, or anything with fluid or puss oozing out should be reported and looked at by your doctor or nurse. They need to check for any possible signs of infection. Any area of concern that have lasted over a period of days and doesn’t seem to be getting better, or is getting worse, needs to be looked at by your physician. Do not ignore any type of skin problem.
Finding the right ostomy pouching system, appliances and accessories may take some time trial and error at first. The products shown to you by your ostomy nurse may not exactly be the right fit for you. A number of new patients often are not aware of the wide variety of manufacturers and products designed for colostomy patients. They take and make use of what they are given after their surgery as best they can. Every patient is different with different stoma sizes and locations and different skin types and contours. What might work for one patient may not meet the needs of another. A colostomy appliance that fits correctly around the stoma is the first form of protection against peristomal skin issues. If a certain adhesive causes skin irritation you may have to try the use of some tapes or vice versa. If the shape of your stoma or the skin around your stoma is an odd shape you may want to try stoma paste to fill the gaps. It is important to be as flexible and adaptive as possible until you find the right combination that works and gives your skin the best form of defense. It may seem like a daunting task at first, but after a little time stoma skin care will just be part of the daily routine of living a healthy life with a colostomy.