A stoma dressing is a specialized medical product designed to manage a surgically created opening, known as a stoma, on the body. A stoma is a surgically created opening on the body, allowing waste products to exit when the natural system is not functioning properly. The fundamental purpose of a stoma dressing is to provide a secure and hygienic environment around the stoma. It collects output, protects the surrounding skin, and supports the well-being of individuals living with a stoma.
Understanding Stoma Dressings
Stoma dressings serve multiple functions beyond simply collecting waste. A primary function is protecting the peristomal skin. This skin can be susceptible to irritation and breakdown from exposure to bodily fluids, so the dressing creates a barrier to shield it. The dressing also absorbs any discharge or secretions from the stoma, which helps prevent maceration.
Stoma dressings also provide secure fixation for the collection pouch, ensuring it remains in place and prevents leakage. They are designed to adhere firmly to the skin while being gentle enough to minimize trauma during removal. The materials used often allow for aeration of the skin, which can contribute to healthy skin and wound healing.
Different Types of Stoma Dressings
Stoma dressings vary to suit individual needs and stoma characteristics. One common differentiation is between one-piece and two-piece systems. One-piece systems have the adhesive skin barrier and the collection pouch permanently joined as a single unit, offering simplicity in application. Two-piece systems, conversely, allow the pouch to be detached and reattached to a separate adhesive skin barrier or wafer, providing flexibility for pouch changes without removing the entire system.
Skin barriers themselves can vary in design, including flat or convex shapes. Flat barriers are suitable for stomas that protrude well, while convex barriers are curved to apply gentle pressure inward on the skin, helping to manage retracted or flush stomas and improve the seal. Adhesives also differ, with some made from hydrocolloid materials that form a gel upon contact with moisture, providing a protective and absorbent seal. Other variations include pre-cut openings for standard stoma sizes or cut-to-fit barriers that can be customized to the stoma’s exact shape and size.
Applying and Maintaining Stoma Dressings
Application begins with thorough skin preparation. Wash the area around the stoma with warm water and pat dry. Avoiding soaps, lotions, or creams prevents skin irritation and ensures better adhesion. If the skin is oily, an alcohol wipe can be used to clean it before application.
Once the skin is clean and dry, the new dressing can be applied. If using a cut-to-fit barrier, the opening should be carefully measured and cut to match the stoma’s size, ensuring a snug fit to prevent leakage. The protective backing is then removed, and the adhesive barrier is positioned around the stoma, pressing gently from the center outwards to secure it smoothly against the skin. For two-piece systems, the pouch is then snapped or connected to the barrier.
Routine maintenance involves regularly emptying drainable pouches when they are about one-third to half full to prevent excessive weight and potential leaks. The entire pouching system is changed every 3 to 7 days, or sooner if there are signs of leakage or discomfort. When removing the old dressing, gentle peeling while pressing down on the skin helps minimize skin stripping.
Managing Stoma Dressing Challenges
Even with proper application, individuals with stomas may encounter certain challenges. Peristomal skin irritation is a common issue. It can manifest as redness, itching, or soreness, often caused by effluent leakage, an improperly fitting barrier, or allergic reactions. Ensuring the barrier opening is the correct size and fits snugly around the stoma can help prevent output from contacting the skin.
Pouch leakage is another frequent concern, leading to discomfort and skin problems. It can result from a poor seal, an ill-fitting barrier, or an overfull pouch. Barrier rings or paste can fill uneven skin surfaces, creating a better seal and reducing leaks.
Odor management is also a consideration; while modern pouches have filters, some individuals may use lubricating deodorizers inside the pouch to neutralize smells during changes. Ballooning, where gas accumulates in the pouch causing it to inflate, can be managed by avoiding carbonated beverages or foods known to produce gas, and for some systems, releasing air throughout the day. If persistent issues arise, consult a stoma care nurse to identify the cause and find solutions.