Daily nursing care of enterostomy should pay attention to the following points:
First, because the skin around enterostomy is easily polluted and damaged by feces, ostomy bags are used to protect the skin. Under normal circumstances, the skin around enterostomy should be intact, but if the ostomy bag is used improperly, it will easily lead to redness, damage, erosion and infection of the skin. Skin injury around enterostomy is the most common complication. The main reasons are as follows:
1. The cutting size of the bottom plate of the ostomy bag is not suitable. If it is too small, it will affect adhesion, and if it is too large, the skin will be polluted by stool. The correct way is that the cutting size of the bottom plate is 2 mm larger than that of enterostomy;
2. Did not pay attention to observe whether the bottom plate of the ostomy bag has leakage and the degree of leakage, which led to the leakage of fecal water to the skin under the bottom plate. The ostomy bag is usually replaced once every 3-5 days, but it should be replaced in time when leakage occurs;
3. The use of non-stick bags will directly pollute and irritate the skin and cause skin damage. Therefore, it is suggested that only patients with stool formation can use non-stick ostomy bags, and zinc oxide ointment must be used to protect the skin.
4. Failure to master the operation skills of changing ostomy bags or poor skin condition around ostomy leads to unstable sticking of ostomy bags, so it is very important to master the self-care skills of changing ostomy bags. Patients and their families, especially patients, should take the initiative to learn and sum up experience;
If skin injury around stoma is found, the cause should be found out and corrected in time. If possible, it is best to consult an ostomy therapist or come to the hospital for treatment. Light can be applied with ostomy skin care powder, and heavy is recommended to be used under the guidance of dermatologists.
Second, stoma stenosis is also common. Once anastomotic stenosis occurs, it will lead to defecation thinning or difficulty, and in severe cases, it will cause intestinal obstruction. Therefore. Every time the ostomy bag is replaced, the self-examination of stoma stenosis should be carried out. The method is to put on gloves, oil your fingers, gently probe into them, and gradually transition from the thinner little finger to the middle finger to feel whether there is a sense of tightness. If it feels tight, leave it for about 10 minutes, and then replace the thicker finger until the middle finger can be inserted smoothly. For those with obvious anastomotic stenosis, it is recommended to dilate the anus twice a day.
Thirdly, colostomy prolapse and parastomal hernia mostly occur in years or decades after operation. In daily life, we should treat chronic cough, constipation or dysuria in time, avoid lifting or lifting weights and other factors that lead to the increase of intra-abdominal pressure, and at the same time control our weight to avoid excessive weight gain.