All information is correct at time of printing and is subject to change without notice. The Devon Formulary and Referral Website is not in any way liable for the accuracy of any information printed and stored by users. For the most up-to-date information, please refer to the website.
Formulary
Page last updated:
6 January 2023
Contact us about this page
Stoma useful information
There are three main types of stoma; colostomy, ileostomy, and urostomy which require ostomy bags.
The type of stoma will be dependent on the surgical procedure and the anatomy that has been used to form the stoma. This will also determine the output from the stoma.
- Colostomy: the large bowel (colon) is brought to the surface of the abdomen. It may involve any part of the colon e.g. a sigmoid colostomy. The nearer to the rectum the stoma is brought out, the more formed the stool will be.
- Ileostomy: the small bowel (ileum) is brought to the surface of the abdomen. It can be anywhere along the small bowel, but most commonly the terminal ileum is used. The output should be of thick "porridge" consistency.
- Urostomy: a piece of ileum is used to form a conduit and the ureters are attached. The conduit is brought to the surface of the abdomen to form a urostomy. The output will be urine with strands of mucous.
- Mucous fistula: in some cases there will be a mucous fistula which is the distal portion of the bowel brought to the skin surface resembling a colostomy and the output of which will be mucous.
Principles of stoma care
The main principles of stoma care are to provide the patient with a well-fitting, comfortable appliance and to maintain skin integrity.
The skin around the stoma should be protected by ensuring the aperture (hole) of the appliance is cut to the correct size. There should be no more than 1-2mm of exposed skin when the appliance is placed in situ. A measuring guide or template should be used - all patients should be provided with these but, if not, they are available in stoma care resource files or from the stoma care nurse specialist teams. The measuring guide is placed over the stoma and the nearest size chosen.
When a healthcare professional/carer is performing stoma care, standard infections control precautions should be applied.
Patients should not expect to get sore skin around the stoma. If skin is sore refer to descriptions below, products listed on subsequent pages and refer to stoma care nurse specialist service if problem does not resolve.
Normal Skin
The peristomal skin should be pink and healthy and mirrors the skin on the rest of the patient’s abdomen. On removal of the stoma appliance, the skin may appear slightly pink but this should resolve within a few minutes.
Slightly Pink Skin (mild erythema)
Assess technique especially removal of pouch, which may be causing localised trauma. Ensure that the appliance template is still correct and adjust accordingly.
Treatment guideline – consider use of adhesive remover
Moderately Pink Skin (moderate erythema)
Assess technique, especially removal of pouch. Ensure that the appliance template is still correct and adjust accordingly. There should be no more than 1-2 mm of exposed skin when the appliance is placed in situ. Re-size bag if appropriate.
Treatment guideline - consider use of protective wipes
Red Inflamed, Dry, Angry Skin (severe erythema)
Assess technique, especially removal of pouch. Ensure that the appliance template is still correct and adjust accordingly. There should be no more than 1-2 mm of exposed skin when the appliance is placed in situ. Re-size bag if appropriate.
Refer back to clinician for assessment and rule out infection.
Treatment guideline - consider use of protective barrier wipes
Red, Inflamed and Moist Skin
Assess technique, especially removal of pouch. On removal of the pouch, check for leakage or breeching. Ensure that the appliance template is still correct and adjust accordingly. There should be no more than 1-2 mm of exposed skin when the appliance is placed in situ. Re-size bag if appropriate.
Refer back to clinician for assessment and to rule out infection.
Treatment guideline - consider use of protective barrier wipes and powders
