According to medical statistics, there are more than ten thousand people living in Russia who belong to the category of “ostomy patients”. Who is it? These are patients who, after surgery, the ureter or intestine was removed on the front wall of the abdomen. A similar hole formed as a result of the operation is called the “stoma”. This word has Greek roots. His translation sounds like a "mouth" or "hole".
Need for surgery
The purpose of the stoma is to divert urine or feces. The need for this hole arises when the bladder or intestines are not able to function independently. Various reasons lead to this state. It can be either a birth defect or an injury or illness of an organ.
Of course, certain life difficulties are experienced by ostomy patients. What is it - existence in the absence of a closure apparatus, which is observed in such patients? This is the inability to control the process of emptying the bladder or intestines. This situation makes it very difficult to communicate with people and maintain an active lifestyle.
Types of ostomy
The hole brought to the front wall of the abdominal cavity can be either permanent or temporary. In the first case, it is impossible for ostomy patients to perform an operation in the future that would eliminate their condition. The obstructive apparatus of the bladder or intestines in such patients has irreversible damage. There is also no possibility of rapid restoration of intestinal patency.
Stoma for stool removal is often called an unnatural anus. Moreover, there is the following classification of such holes:
- colostomy (when the colon is excreted);
- ileostomy (excretion of the small intestine);
- single-barrel (with the withdrawal of one trunk of the intestine);
- double-barreled (when on the abdominal wall there are two openings with the removed trunks of the intestine).
Ostomy Care
Excretion of the intestine or ureter into the abdominal region saves the patient's life. If the doctor makes a decision about the operation, then the patient simply has no other choice. Nursing care for ostomy patients requires not complex, but very responsible operations. First of all, they relate to processing artificially created holes. And for this there are special tools, the choice of which will depend on the location and type of stoma. The formation of feces and the preferences of the patient should also be taken into account.
To date, manufacturers offer two types of agents with which effective care for ostomy patients can be carried out. These are adhesive-based one- and two-component kalopriemniki, as well as uroreceivers.
What are these funds? One-component uro- and kalopriyemniki are plastic bags having an adhesive basis. They can be closed (not drained) and open (drained). The second type of tool is characterized by the presence of communication with the environment.
As for two-component receivers, they have two parts. One of them is an adhesive plate, and the second is a bag.
There are certain features for the care of ostomy patients in the case of an inverted form of the outlet. Such patients need to purchase special convex type adhesive plates. Their feature is to be equipped with a rigid flange. They also have special “ears”. Such devices are used to fasten the belt, which must be worn to firmly fix the plate.
An ostomy patient with a colostomy can use either one- or two-component receivers. However, it should be borne in mind that this is possible only if the stool is fully formed, and bowel movement occurs 2-3 times a day.
If a closed-type kalopriemnik is used, the bags in them must be changed up to three times a day, and the plate - once or twice a week.
In the event that the patient has a tendency to diarrhea, then open-type funds should be purchased for him. The same receivers are needed for those patients who have an ileostomy. These funds change less often than closed ones, not more often than once during the day. If the bag does not leak anywhere, then the drained receivers can remain on the skin for up to three days, provided that they are constantly emptied.
Preparation for leaving
Rehabilitation of ostomy patients should take place in parallel with their training. During this period, the patient is taught stoma care rules. In the future, this will allow a person not to feel addiction in the matter of personal hygiene of an artificially created hole.
Those who care for such a patient will need to make a small dressing table. This is an important kit that all ostomy patients use.
What it is? These are items such as:
- scissors (preferably with blunt bent ends);
- a mirror;
- soap for hands;
- a
plastic bag for the disposal of receivers;
- gauze, bandage, soft wipes;
- Uro and kalopriemniki;
- soft towel.
If during the procedure the patient is lying, then it is necessary to lay a waterproof diaper under him . Independent change of the receiver is carried out in a vertical position. For the convenience of the procedure, in this case, you need a mirror.
Change of urine and coloreceps should be done before breakfast or in the evening before bedtime. After eating, this procedure is not recommended.
Ostomy Care
Like any other, this hygienic procedure requires prior hand washing. The use of soap is mandatory. Stoma also needs to be pre-washed. However, you do not need to use soap for this. One warm water is enough. The skin near the hole can simply be treated with a special cleaner. However, it is worth remembering that it is forbidden to clean the stoma with liquids containing alcohol, antiseptic solutions, and ether. All these products, like soap, will dry the skin and remove its natural protective barrier. This increases the risk of mechanical damage to the treated area, as well as the probability of penetration of pathogenic bacteria into the body.
After washing, the skin should be dried. A gauze napkin or a soft towel is used for this. In the absence of constant excretion of feces, it is advisable to dry the skin in the air naturally.
A hairline may be present on the abdomen around the stoma. It must be removed with scissors. Using a razor or depilatory creams is prohibited. These funds will cause irritation of the skin.
Installation of feces and urinals
When using one-component bags, you should immediately deal with the adhesive plate. It is preheated in the hands, the protective coating is removed and glued onto the stoma area in the direction from bottom to top.
Two-way receivers are mounted somewhat differently. A plate is glued on the colostomy, and then a bag is put on its flange. A click indicates its correct fixation. Next, the bag is rotated in a position convenient for the patient, and the fastening ring is closed on it. After clamping the latch with your fingers, another easy click should be heard.
Removal of feces and urinals
In the case of using two-component products, it will be necessary to remove the bag located on the plate. To do this, after pressing the latch with your finger, the mounting ring is opened and the ear of the receiver is pulled up and slightly away from you. In this case, the plate must be held in order to avoid its peeling off.
One component receivers are removed along with the plate. To do this, take a bag with one hand, and hold the skin with the other. Peel off such a receiver carefully, avoiding jerking.
Skin care around the stoma
The area that surrounds the hole to remove urine or feces requires vigilant attention. The patient himself, as well as the specialist, must monitor her condition.
The skin in the area of the hole should be clean, dry and intact. In order to maintain her health, certain patients must adhere to certain rules. What are these recommendations? In their list:
- selection of the correct type of feces or urinal;
- regular emptying and bag change;
- eliminating the possibility of urine or feces on the plate;
- immediate consultation with a specialist in case of reddening of the skin or the appearance of vesicles and sores on them;
- the use of special gels and creams to care for the area around the stoma;
- Compliance with the regimen of food and fluid;
- constant monitoring of the tightness of the plate.
Gastrointestinal problems
As necessary, gas evolution is treated in ostomy patients. Flatulence, which causes an increase in intra-abdominal pressure, is eliminated after the use of enzyme medicines, such as Festal, Panzinorm, etc. The course of treatment leads to the normalization of intestinal microflora.
In case of constipation, ostomy patients should also sound the alarm. What is it, everyone knows. However, patients with stoma especially need to eliminate this phenomenon, which provokes, among other things, the loss of small segments of the intestine. To do this, it is recommended to bring the fluid intake to two liters per day. Need to change and nutrition of patients ostomy. The menu will need to include the maximum number of fiber-rich foods. In this case, the high physical activity of the patient is important. Constipation can also be treated with enemas in the stoma area, as well as oral laxatives.
Psychological support
Some patients are extremely disgusted with their stoma. They either defiantly do not pay attention to it, or behave very aggressively at the mention of an existing problem. It is advisable for such people to seek the help of a psychologist or psychotherapist. It is also important to explain to the patient about the vital necessity of imposing a stoma on him and the undesirability of a squeamish attitude towards her.
Problem in women
An ostomy patient often asks about the possibility of becoming pregnant and having a baby. Obstacles to this do not exist. The main thing is that during the operation the ovaries and uterus are not affected.
Important point
Having made the decision to have a baby, the patient should be consulted with the surgeon treating her. Such an important life step can be taken only after the approval of a specialist. The entire period of pregnancy in such patients proceeds without any complications. Safely and on time, the birth takes place. Only they, as a rule, are carried out using cesarean section.
The purchase of special underwear
Of course, ostomy patients have their own characteristics. In this regard, they need to wear special underwear. It is sewn with an inner pocket in which a kalo or urinal is placed. This gives additional confidence to the patient. The plate on his skin will remain airtight and will not go away under the weight of the filling bag.
Underwear for ostomy patients will also help maintain the health of the area around the opening in the abdomen. The fact is that a bag placed in a pocket will not rub the skin, since it will have no contact with it. A person wearing such underwear can calmly, without any discomfort, change clothes in the locker room and in the changing room. Nobody will notice the presence of the bag, since the weight of the receiver will be completely distributed along the entire abdomen. As for outerwear, then for ostomy patients there are no restrictions in its choice. They can wear the same things that they had before the operation. The main thing is that the wardrobe items are not too tight.