Sedigheh Aghaei BSN –ETN WOCN

 Infection  Bleeding  Stomal edema  Excessive secretion  Necrotic stoma tissues  Mucocutaneous separation

Cause: Deficient blood supply Management: Observation Surgical revision

 Stomal ulcer  Stomal Retraction 1. Stoma Prolepses  Stomal Stenosis  Stomal hernia

Prolapse RetractionStenosis NecrosisHerniationPhosphatic Deposits

Causes: Weakened abdominal muscles Inadequate surgical suturing Management: proper stoma siting avoid lifting heavy objects Use flexible appliances surgery if blood supply impaired

Cause:  Scar tissue formation  Stoma retraction Management:  Prevent excoriation/scar formation  Dilatation  Surgical reconstruction

Causes:  Weakened abdominal muscles  Oversized incision opening  Heavy lifting  Ascites  Disruption of internal attachments securing the bowel

 Observe for color changes in stoma  Reduce swelling  Manual reduction before base plate  Measure base of stoma  Surgical correction

May occur immediately post-Op  Necrosis of stoma tissue with scar  Tension on the bowel the  Weight gain cause fatty tissues to bulge outwards around the stoma  complication of chemotherapy

Tight base plate most common cause

Causes :  Tight base plate most common cause  Rad  Cut base plate too fit Management:  Remove cause  Use barrier wipe  Get a good seal on the appliance & protect the skin  Correct leakage  Cut base plate fit

Priostomal Skin Problems

 Allergic skin reactions  Contact Dermatitis  Folliculitis  Maceration  Bacterial Infection  Fungal Infection Candidacies

Allergic skin reactions Causes: Skin cleanser Skin protector Appliance & Dressings. Tape Radiotherapy Poor hygiene Priostomal Skin Problems

Causes :  Long term ileostomate  Stoma output 600 ml daily of faeces  Sore skin for 2 weeks  Poor stoma sitting

Causes:  wafer opening too large  improperly fitted skin barrier or poor adhesive  Priostomal skin folds /creases  leakage underneath wafer not attended to  Priostomal skin not properly cleaned Management:  remove cause  correct leakage  Stomahesive powder  Skin barrier

Cause:  Removal of hair from follicles by aggressive adhesives Management:  Shave Priostomal hair  Use barrier wipe  Corticosteroid spray

Cause:  prolonged contact with alkaline urine  wafer used for too long  opening too large Management:  Add 1-2 drops of vinegar in cleansing fluid for cleansing  Increase fluid intake Vit C