Colostomy Care for Pediatric Patients

Colostomies:
a. Newborns created to relieve

bowel obstruction caused by conditions such as ileal atresia, necrotizing enterocolitis and imperforate anus. b. Older children constructed for conditions such as IBS, and Hirschsprungs disorder

 To protect underlying skin, do not

remove a self-adhering bag if it is full, but drain collected stool from the bottom of the colostomy bag into a basin or paper cup for disposal.

To remove a bag that was placed with

a sealant, be certain to use the designated solvent to prevent pulling or harming underlying skin. Then wash the solvent away with soap and water or it will become an irritant itself.

 Check the dressing approximately

every 4 hours. Remove and replace it when soiled, washing the skin well and applying new powder as necessary.

Turning an infant from side to side

every after feeding may be helpful in keeping stool from flowing continuously to one side. Leaving the abdominal skin exposed to air at least 1 hour per day also helps protect skin integrity.

 In irrigating colostomies for children, the amount

is typically small, approximately 40-100ml in infants. Normal saline (0.9% sodium chloride) should be used in place of tap water, which could lead to water intoxication.

Stress to parents that stoma has no nerves, so a

parent can feel free to wash it without hurting the child and that compression against the stoma will not cause a child pain.

END