Learning how to properly clean the stoma and the surrounding skin, known as the peristomal area, is a manageable but important part of daily life with a colostomy. Routine hygienic care helps prevent skin irritation, maintains a secure pouch seal, and ensures comfort and confidence.
Essential Supplies and Preparation
Gathering all necessary items ensures a smooth and efficient pouch change. You will need a new, correctly sized pouching system, which may include a skin barrier wafer and a collection pouch, depending on the system type. Keep a disposal bag ready to contain the used appliance and any soiled materials, reducing mess and odor.
It is helpful to have non-woven gauze or soft wipes, lukewarm tap water, and a medical-grade adhesive remover wipe or spray. While many people only use water for cleaning, a mild, non-oil-based soap may be recommended by a healthcare professional, so have that ready if applicable. Wash your hands thoroughly and ensure you are in a comfortable, well-lit location to minimize contamination risk and allow a clear view of the peristomal skin.
Step-by-Step Cleaning Technique
Gently remove the used pouching system by peeling it away carefully while simultaneously pressing down on the skin to avoid trauma. If the appliance is adhering strongly, a medical adhesive remover applied to the edge of the barrier can help dissolve the sticky residue for a less painful lift. Once the used barrier is off, you can cover the stoma opening with a piece of gauze to manage any output that occurs during cleaning.
The stoma and the surrounding skin should be cleaned gently using warm tap water and soft gauze or a non-woven wipe. The goal is to remove all effluent and any adhesive residue without scrubbing, as the stoma’s tissue is delicate and rich in blood vessels. If a mild soap is used, it should be thoroughly rinsed off, since residue can interfere with the adhesion of the new barrier.
Use a clean, soft towel or gauze to gently pat the peristomal skin dry, making sure not to rub the area. Any moisture remaining on the skin can weaken the adhesive and lead to a premature loss of the seal, increasing the risk of skin irritation from stoma output. A fully dry skin surface is essential for reliable attachment of the new pouching system.
Protecting the Peristomal Skin
Specialized products are used after cleaning to create a protective interface and maintain the integrity of the peristomal skin. A no-sting barrier wipe or spray, often containing silicone, can be applied to the dried skin to form a thin, protective film. This invisible layer shields the skin from abrasive adhesives and corrosive stoma output.
Next, a barrier ring or seal, a moldable, hydrocolloid-based product, can be placed directly around the base of the stoma. This material acts like a caulk, filling in any uneven skin surfaces, dips, or creases to ensure a snug fit and prevent effluent from leaking underneath the pouching system. The ring is gently molded to the stoma’s shape and size, ensuring there is no exposed skin between the stoma and the barrier.
If the peristomal skin is already irritated, weeping, or moist, a small amount of stoma powder may be dusted onto the affected area before the barrier film is applied. Stoma powder is designed to absorb moisture and create a dry surface for the adhesive to stick to, promoting healing. Any excess powder must be lightly brushed or dabbed off, as thick layers can prevent the barrier from adhering securely to the skin.
Recognizing Signs of Complication
Visually assess the stoma and the surrounding skin for any changes during the cleaning process. A healthy stoma should appear beefy red or pink, moist, and slightly raised above the skin surface. Because it is mucosal tissue, minor spotting of blood on the gauze during cleaning is common and does not indicate a problem.
However, certain visual cues suggest a complication and require consultation with a healthcare provider or ostomy nurse. These include significant color changes, such as the stoma becoming pale, dusky, or black, which could signal a compromise in blood flow. Persistent bleeding that is more than just minor spotting is a sign requiring medical attention.
Skin complications around the stoma, such as a severe rash, deep redness that does not clear up, or open sores, often point to irritation from leakage or a fungal infection. Other concerning signs are a foul odor unrelated to the stoma output, a firm bulge around the stoma that might suggest a hernia, or a sudden change in the stoma’s size or shape, like retraction or prolapse. Observing these indicators allows for timely intervention to keep the stoma site healthy.