INTRODUCTION

Colostomy is a surgically created opening between the colon and the abdominal wall for the fecal
elimination.Taking good care of a stoma and knowing what to watch for is extremely important in
preventing any untoward complication.

DEFINITION
Colostomy is an opening, called a stoma in the large intestine brought to the surface of the abdomen for the
purpose of evacuation of bowel.

TYPES OF COLOSTOMY
ACCORDING TO DURATION
• Permanent Colostomy
• Temporary Colostomy

ACCORDING TO STOMA SITE

• Ascending Colostomy
• Transverse Colostomy
• Descending Colostomy

ACCORDING TO STOMA NUMBER & TYPE

• Single – Barrel Colostomy
• Double – Barrel Colostomy
• Loop Colostomy

INDICATION FOR COLOSTOMY

1.Colon Cancer
2.Hirschprung’s Disease
3.Ulcerative Colitis
4.Polyps in Intestine

PURPOSE OF COLOSTOMY CARE

1.Skin protection & care
2.Receptacle for drainage
3.Patient acceptance & self care

ARTICLES REQUIRED
A clean tray containing
• Mackintosh with draw sheet
• Kidney tray/paper bag
• Pair of clean gloves
• Colostomy bag
• NS/Basin with warm tap water
• Gauze pieces
• Gauze pad/tissue paper
• Skin barrier
• Stoma measuring guide
• Pen or pencils & scissors
• Bed pan
 PROCEDURE

NURSING ACTION RATIONALE

1) Gather equipment. 1. Ensure that everything is there to render the
care.
2) Encourage clients to look at the stoma. 2. It encourages participation in the stoma care.
3) Explain the procedure to the patient.
4) Provide privacy. 3. To gain confidence of the patient.
5) Perform hand hygiene & wear gloves .
Spread mackintosh & draw sheet. 4. For smooth performance of procedure.
6) Remove used pouch & skin barrier 5. To prevent infection. To protect linen
gently by pushing the skin away from
the barrier
7) . Remove clamp and empty the content 6. Reduces trauma, jerking, irritates skin & can
into bed pan. Rinse the pouch with tepid cause tear.
water/NS.
8) Discard the disposable pouch in paper 7. To minimize the odour & growth of microbes.
bag.
9) Observe stoma for colour, swelling,
trauma & healing. Stoma should be
moist & pink
10) . Cover the stoma with a gauze piece. 8. To find out complications
11) Clean peristomal region gently with
warm tap water using gauze pad. Don't
scrub the skin, dry by patting the skin 9. To prevent the faecal matter from contacting
12) . Remove gauze & clean stoma with with skin.
gauze Measure the stoma using 10. Stoma surface is highly vascular. Skin barrier
measuring guide. does not adhere to wet skin.
13) Trace same circle behind the skin
barrier, using scissors, cut an opening
1/16 to 1/8 inch larger than stoma 11. Ensure accuracy in determining correct pouch
before removing the wrapper over size needed.
adhesive part
14) . Put skin barrier & pouch over the
stoma, & gently press on to the skin, for
1-2 min. Use the pouch if it is drainable
using a clamp or clip.
15) Remove gloves and wash hands.
16) Make the patient comfortable. 12. To prevent irritation to skin
17) Clean the area and replace all articles
DOCUMENTATION
Record the procedure with following
details:
• Date/Time
• Amount
• Colour
• Consistency of faecal matter
• Sign of any infection
COMPLICATIO NS
• Necrosis of Stoma
• Retraction of Stoma
• Prolapsed of stoma
• Stenosis or Narrowing
• Parastomal hernia
REFERENCES

1. Clement I. Textbook of NURSING FOUNDATIONS. 1 st Edition. New Delhi: Jaypee Medical Brothers
Publishers; 2011. P. 142-160.

2. Ghai.S, Rana K.A, Kaur S., Sharma S., Saini K.S. Clinical Nursing Procedures. 1 st Edition. New Delhi:
CBS Publishers; 2018. P. 8-19.
rd
3. Jacob. A, R. Rekha, Tarachand S.J. Clinical Nursing Procedures: The art of Nursing Practice. 3 Edition.
NewDelhi: Jaypee Medical Brothers Publishers; 2015. P. 2-14, 225-227.

4. Nancy.Sr. Stephanie’s Principles & Practice of NURSING.Vol. 1. 7 th edition. Indore: N.R.Publishing

House; 2017. P. 193-210.

5. Sethi N. NURSING PRINCIPLES AND PRACTICE. Vol. 1. 2 nd Edition. Jalandhar: LOTUS Publishers;
2013. P. 402-458.