A stoma is a surgically created opening on the abdomen that allows waste, such as stool or urine, to exit the body into an external collection pouch. This opening is formed when a portion of the digestive or urinary system is brought through the abdominal wall. It appears pink or red, feels moist like the inside of the mouth, and generally causes no pain due to a lack of nerve endings. Understanding the appropriate duration and practices for uncovering is important to maintain skin health and prevent potential complications.
Recommended Uncovering Duration
A stoma should be left uncovered for the shortest time possible, typically only a few minutes. This brief period occurs during ostomy appliance changes or skin care routines. For instance, during a pouch change, the stoma might be uncovered for 5 to 10 minutes. This brief exposure allows for necessary cleaning and inspection while minimizing complication risks.
The reason for this short duration is to protect the peristomal skin, the area immediately surrounding the stoma. Stoma output can irritate the skin, especially from ileostomies, where the watery output contains corrosive digestive enzymes. A secure pouching system continuously protects this sensitive skin. While some individuals may shower without their appliance, this is a temporary situation where output is managed, not exposed to waste.
Purposes for Brief Uncovering
Briefly uncovering a stoma serves several purposes related to hygiene and assessment. The main reason is to facilitate changing the ostomy pouch or appliance.
During this brief period, the skin around the stoma can be thoroughly cleaned. It also allows for inspection of the stoma and surrounding peristomal skin for changes like redness or irritation. After cleaning, the skin must air dry completely before a new appliance is applied to ensure proper adhesion and prevent skin problems.
Consequences of Prolonged Uncovering
Leaving a stoma uncovered for too long can lead to several adverse outcomes. A common issue is irritation and damage to the peristomal skin. Direct exposure to waste, especially acidic ileostomy output, can cause maceration, redness, itching, and skin breakdown. This can be painful and hinder proper appliance adhesion.
Prolonged uncovering also increases vulnerability to infections. The exposed stoma and surrounding skin become more susceptible to bacterial or fungal growth due to moisture and waste. Without a collection device, waste can leak uncontrollably, causing discomfort, odor, and embarrassment. This can also impact an individual’s confidence and quality of life.
Care Practices for Uncovered Stoma
When the stoma is briefly uncovered, specific care practices ensure hygiene and skin protection. Have all necessary supplies ready before removing the old appliance to minimize uncovered time. Gently clean the peristomal skin with warm water; a mild, residue-free soap may be used if recommended by a healthcare professional.
After cleaning, pat the skin completely dry to facilitate proper adhesion of the new appliance. Apply any prescribed skin barriers or protective powders to safeguard the skin. During this brief exposure, use a tissue or gauze to gently absorb any stoma discharge, preventing unnecessary skin contact.