Cleaning a colostomy stoma is an important part of daily self-care. This routine practice is fundamental for maintaining the health of the stoma and surrounding skin, contributing to comfort and overall well-being. Regular cleaning helps prevent potential complications, making it an essential aspect of daily life.
Essential Supplies for Stoma Care
Preparing necessary items before cleaning simplifies the routine. Warm water, without additives, is typically sufficient for cleaning the stoma and surrounding skin. A mild, unscented soap can be used if desired, but it should be free of lotions or harsh chemicals that could irritate the skin.
Soft, disposable wipes or clean washcloths are used for gentle cleaning and drying. For the new pouching system, ensure all components are available, including the skin barrier or wafer, and the ostomy pouch. Some individuals may also need ostomy-specific products like barrier rings, paste, or powder, which provide additional protection for the peristomal skin. Having these items organized and within reach ensures a smooth and hygienic process.
Step-by-Step Stoma Cleaning Procedure
Begin by carefully removing the used ostomy pouch and skin barrier. Gently peel the adhesive barrier away from the skin, starting from the top and working downwards, while supporting the skin with the other hand. This slow, deliberate motion helps prevent skin stripping and irritation. Dispose of the used pouch and barrier appropriately.
After removing the old system, visually inspect the stoma and the surrounding peristomal skin. The stoma should appear moist and reddish-pink, similar to the inside of the mouth, and may move slightly or bleed a small amount, which is normal. Observe the skin for any signs of redness, rash, or breakdown to identify issues early.
Use a soft, clean cloth or disposable wipe dampened with warm water to gently clean the stoma itself. Wipe from the stoma outwards to the surrounding skin, ensuring any stool or mucus is removed. If using a mild soap, apply it sparingly to the cloth and gently cleanse the skin around the stoma. Avoid scrubbing or applying excessive pressure, as the stoma tissue is delicate.
Rinse the area thoroughly with clean, warm water to remove all traces of soap, if used. Residual soap can cause skin irritation or interfere with the adhesion of the new skin barrier. After rinsing, carefully pat the skin completely dry using a clean, soft towel or paper towel. Ensuring the skin is dry is important for the new adhesive to create a secure seal.
Preventing and Managing Peristomal Skin Irritation
Maintaining the health of the skin around the stoma, known as peristomal skin, is important for comfort and preventing complications. Skin irritation can arise from prolonged exposure to moisture, leakage of stoma output onto the skin, or allergic reactions to adhesive products. Consistent skin care practices help prevent these issues.
Ensuring a proper seal with the ostomy pouching system is an effective preventative measure against leakage. The size of the opening in the skin barrier should precisely match the stoma’s size and shape, leaving no exposed skin around its base. Using a barrier ring or paste can help fill in any irregularities in the skin surface, creating a flatter, more secure adherence area.
Thorough drying of the peristomal skin after cleaning is also important. Moisture left on the skin can promote bacterial or fungal growth and lead to maceration, where the skin becomes soft, white, and prone to breakdown. Applying a skin barrier wipe before placing the new pouching system can create a protective film, shielding the skin from irritants and enhancing adhesive adherence. Regular inspection helps ensure the skin remains intact and healthy.
When to Seek Medical Guidance
While proper stoma care helps prevent many issues, certain signs and symptoms warrant attention from a healthcare professional, such as an ostomy nurse or a doctor. Persistent or significant bleeding from the stoma itself, beyond a few drops during cleaning, should be evaluated. Changes in the stoma’s color, such as dark purple, black, or pale, indicate a potential problem with blood supply and require urgent medical assessment.
Severe or spreading skin irritation around the stoma that does not improve with routine care necessitates professional advice. Signs of infection, including increasing redness, warmth, swelling, pain, or pus around the stoma or in the surrounding skin, are indicators of concern. Any significant change in the stoma’s size or shape, particularly if it retracts or prolapses, should also be reported to a healthcare provider. Unexplained or persistent leakage that cannot be resolved with adjustments to the pouching system also warrants medical consultation.