Kolostoma - what is it? Colostomy: postoperative care

Kolostoma - what is it? How to behave with her, what can and can not be, what kind of care does this type of stoma require? All these questions are asked by people who have a temporary or permanent colostomy.

Definition of the concept of "colostomy"

What it is? Kolostoma is an artificially excreted part of the large intestine on the anterior abdominal wall after surgery on the lower intestine.

It is necessary for excretion of metabolic products in cases where it is necessary to bypass the rectum after surgery for tumors, traumas and some inflammatory diseases of the large intestine requiring surgery (Crohn's disease, ulcerative colitis). Constant colostomy of the rectum is indicated in cases where restoration of the lower intestine is not possible.

A healthy person can control the process of bowel evacuation. This is achieved with the help of sphincters, whose activity is provided by a conditioned reflex and depends on the nerve impulses coming from the cortex of the brain. Through the colostomy the stools come out 2-3 times a day in the form of a decorated or semi-formal stool, the activity of the intestine is not disturbed.

Types of colostomy

There are several species of colostrum:

• Temporary or permanent;
• Single-barreled or double-barreled:
• Separate or loop.

Constant colostomy is established for life, there are no opportunities for its elimination because of irreversible changes in sphincters or with a significant malignant degeneration of the rectum. After a while, the temporary colostomy is removed by surgery, with the restoration of patency of the large intestine.

One-barrel - through the hole one trunk of the intestine is removed, double-barreled - two. Loop colostomy - two openings are located side by side, separate - at some distance from each other.

Kolostoma - what is it? What kinds of it are, which is more acceptable in each case? All these questions will be answered by a surgeon or a nurse who has completed specialized courses. Colostomy after the operation on the intestine looks like a hole or a mouth through which the large intestine comes to the surface of the abdomen. At first it is inflamed and considerably protrudes above the surface of the skin. Then the puffiness gradually decreases, the mouth turns into a small hole, through which the stools freely leave on the surface of the anterior abdominal wall. Nerve endings do not have colostomy, so you need to be extremely careful not to damage the hole. The constant allocation of white mucus is a normal process, one should not be afraid of it.

Necessity of colostomy

Many people do not know what constitutes a colostomy. What is this adaptation, they learn only in the hospital. And because often frightened ask a question about whether it is possible to live with her normally. It excites any person who is offered such an operation. The artificial exit of the large intestine is necessary for the removal of stool. Sometimes it saves and prolongs a person's life.

Do not be frightened that there is no urge and the ability to normally empty the intestines in a convenient place and at a convenient time. With proper care for colostomy, the quality of a person's life does not change, he can lead a full-fledged way of life, without restraining his illness. Currently, there are a large number of kalopriemnikov that are well attached to the skin, do not skip smell, do not rustle and are not visible to others, and with proper care and do not irritate the skin.

Having a colostomy, a person changes, especially emotionally and physically: he loses interest in life, feels hurt and inferior. In some cases, patients get disabilities and become withdrawn, think about suicide. Do not worry about this, because it's not hard to care for the colostomy. Before the operation, the surgeon will specify the place of excretion of the large intestine with the aim that the patient is comfortable to see and care for her. After the operation, the nurse will tell and show what needs to be done so that the colostomy does not interfere, what kind of kalopriemniki should be worn immediately after the operation, and which after some time.

Only according to strict indications, an operative intervention is carried out to remove part of the intestine to the anterior abdominal wall, the doctor must ensure that colostomy is formed without complications.

The operation to eliminate the mouth and form a natural patency of the intestine is a complex process that can last in several stages for people who have a colostomy. Restorative surgery by doctors is carried out without much enthusiasm due to the high risk of complications, the complexity of this type of surgery and disbelief in the cure. Colostomy of the rectum is most often formed with cancer lesions, injuries and anorectal incontinence, because in most cases it is permanent.

How to care for the colostomy

Care for the colostomy begins immediately after the operation. Initially, the patient is helped by a nurse, changes, rinses it, and then teaches him to do it himself.

Colostomy requires attentive treatment and care, which consists of two stages: the direct processing of the hole and the change of the calico. First, when forming the stoma, it is necessary to remove stools, rinse the mouth with warm boiled water , wash the skin and dry with gauze napkins. Then it is necessary to apply on the skin ointment "Stomagesive" or Lassar paste. Then, around the hole, put a napkin soaked in petroleum jelly so that the mouth remains. Top with sterile gauze, cover with cotton and put on a bandage. It is advisable to change the bandage every 4 hours. After the formation and healing of the stoma, you can use the kalopriemniki. Formed stoma is considered in the case when there is no inflammatory infiltrate, and the mouth does not protrude above the surface of the skin. After that, you can stick the kalopriemniki.

People who have had a colostomy to change the kalopriemnik must be in the morning or before bedtime. To replace the kolohopryemnika carefully, without delaying the skin, remove the used device and, wrapping in paper, discard it. Remove the remains of stool and wash the colostrum with warm boiled water. You can use liquid soap with an antiseptic. After this, it is necessary to dry the skin well and apply paste or ointment. The measurement requires measuring the size of the stoma and increasing the opening in the calico to such a size that it completely accommodates the opening of the colostomy. If you use adhesive kologopriemniki, it is required to combine the orifice of the stoma with the opening of the kalospriemnika, with a small push to press it against the skin. It is important to ensure that there are no folds. In this case, the latch must be in the closed position.

Types of kalopriemnikov

There are one-component and two-component kologopriemniki. The latter have an adhesive plate and stoma bags, which are connected together by a flange. However, their inconvenience is that skin irritation may occur. Therefore, when using them, the plate can be left for 3-4 days and change only the bag. To unfasten the plate earlier it is necessary at occurrence of a dyscomfort: an itch and a burning sensation or at strong pollution. It is very convenient that the bag has a special filter that removes odor and excess air. One-component must be changed after 6-8 hours, when using two-component, only the bag changes, the plate - 2 times a week.

Rules for gluing the kalopriemnikov

Each calico has a special stencil for measuring the opening of the stoma. If there is no such ruler, you can use a transparent film, which must be applied to the mouth and circled with a handle, then cut out in the film this hole, put on paper, outline the edges of this oval and cut out the hole. On the glutinous plate of the kalospriemnika a hole is cut 2-3 mm larger than the size of the mouth. Glue it with smoothing movements after a slight warming and removing the protective film from the bottom up, so that the lock is on top to facilitate further removal.

If the bag is provided with a drain bag, it must be emptied after the bag has been filled to one-third. This can be done over the toilet, opening the drainage hole, then rinse and dry the fecespot. After treatment, do not forget to close the drainage hole.

Skin care

Skin under colostomy is subjected to constant irritation. Therefore, it is necessary to take care of it properly to prevent inflammation and trauma. For the treatment of the skin there are several types of effective drugs, the main purpose of which is to protect the skin from the aggressive action of the glutinous base of the plate of the calicator and feces.

For gluing the plate, paste "Koloplast" with a small alcohol content is used. It does not irritate even inflamed and injured skin and promote better fixation of the calico.

Clean the skin after the peeling off the kologopriemnika help paste "Klinser", which is used for healthy and slightly damaged skin. It not only cleans the skin of feces, mucus and chemicals glutinous base, but also does not dry it and has antiseptic properties.

Good reviews of consumers received a protective film "Second skin". It is used before gluing the kalospriemnika. Creating a protective layer, it protects the skin from irritation by aggressive media and subsequent inflammation and allows it to breathe.

Proper nutrition of patients with colostomy

There are no special restrictions in the admission of certain products. However, it should be remembered that it is better to avoid food that causes liquefaction of the stool or helps to reduce intestinal motility: white bread, rice broth, tea, cocoa, some fruits and vegetables, etc. To stop the unpleasant odor from colostomy, do not abuse onions, garlic, alcohol , Boiled eggs. Food should be eaten frequently and in small portions. After the operation, you should gradually expand the diet and switch to normal diet.