Sedigheh Aghaei BSN –ETN WOCN

Sedigheh Aghaei

BSN –ETN

WOCN

Infection Bleeding Stomal edema Excessive secretion Necrotic stoma tissues Mucocutaneous separation

Cause:

•Deficient blood supply

Management:

•Observation

•Surgical revision

Stomal ulcer Stomal Retraction1.Stoma Prolepses Stomal Stenosis Stomal hernia

Prolapse Retraction Stenosis

Necrosis Herniation Phosphatic Deposits

Causes:

•Weakened abdominal muscles

•Inadequate surgical suturing

Management:

•proper stoma siting

•avoid lifting heavy objects

•Use flexible appliances

•surgery if blood supply impaired

Cause: Scar tissue

formation Stoma retractionManagement: Prevent

excoriation/scar formation

Dilatation Surgical

reconstruction

Causes: Weakened abdominal

muscles Oversized incision opening Heavy lifting Ascites Disruption of internal

attachments securing the bowel

Observe for color changes in stoma Reduce swelling Manual reduction before base plate Measure base of stoma Surgical correction

May occur immediately post-Op

Necrosis of stoma tissue

with scar Tension on the bowel the Weight gain cause fatty

tissues to bulge outwards around the stoma

complication of chemotherapy

Tight base plate most common cause

Causes :Tight base plate most common causeRad Cut base plate too fitManagement:Remove causeUse barrier wipeGet a good seal on the appliance & protect the skin Correct leakageCut base plate fit

Priostomal Skin Problems

Allergic skin reactions Contact Dermatitis Folliculitis Maceration Bacterial Infection Fungal Infection Candidacies

Allergic skin reactionsCauses:• Skin cleanser• Skin protector• Appliance & Dressings.• Tape • Radiotherapy• Poor hygiene

Priostomal Skin Problems

Causes :Long term ileostomateStoma output 600 ml daily of faecesSore skin for 2 weeksPoor stoma sitting

Causes: wafer opening too large improperly fitted skin barrier or poor adhesive Priostomal skin folds /creases leakage underneath wafer not attended to Priostomal skin not properly cleaned

Management: remove cause correct leakage Stomahesive powder Skin barrier

Cause: Removal of hair

from follicles by aggressive adhesives

Management: Shave Priostomal

hair Use barrier wipe Corticosteroid

spray

Cause: prolonged contact with

alkaline urine wafer used for too long opening too large

Management: Add 1-2 drops of vinegar

in cleansing fluid for cleansing

Increase fluid intake Vit C