• A stoma is an artificial surgical opening,

• which is created as a means of diversion for

faeces or urine to the surface of the skin.
• Bersifat temporer ataupun permanen.
Ditentukan dari berbagai macam kondisi.
• CRC, Bladder Cancer, Chron disease,
Anoperineal Trauma (Kelly O’Flynn, 2016)
 Stoma Complications and Treatments
• Mucocutaneous separation
• Bowel obstruction
• Prolapse. A prolapse can be caused by
weakened abdominal muscles, obesity,
ongoing constipation, or chronic coughing.
• Granulomas
• Urostomy mucous secretion
• High output ileostomy
 Assessment
• A comprehensive assessment of the patient
• Williams et al, (2010) Stoma Care Ostomy
Research (SCOR) assessment tool
• Chandler and Lowther (2013) and Burch
(2014a) recommend that correct size for a
stoma template is 2–3mm from the edge of
the stoma to prevent contact dermatitis.
• Taylor (2012) and Cronin (2005) suggest when
a stoma is poorly spouted (when the bowel
does not protrude far enough away from the
abdominal skin to prevent skin irritation)
• a convex appliance may be beneficial, as it
allows for pushing of the flange of the
appliance up against he abdominal wall,
allowing the stoma to sit further into the
stoma bag adhered to the flange.
• A convex appliance should not be used in
conditions such as pyoderma gangrenosum,
mucocutaneous separation, Crohn’s disease
and parastomal hernias (Burch, 2014a).
 Peristomal skin complications and causes

• Contact dermatitis
• Candida—this is characterised by symptoms of
very sore skin, itching and white pustules.
• Peristomal pyoderma gangrenosum—this is an
extremely painful skin condition, which affects
50% of patients with inflammatory bowel disease
• Skin stripping—this can occur when the outer
layer of the skin has been pulled off along with
the stoma pouch.
 KEY POINTS

◆ The continuity of care for the rehabilitation of

patients with stomas is the weakest link in
community services
◆ Effective communication and collaboration
between district nursing teams and stoma
specialist nurses is essential to support patients
through the period of adaptation to life with a
stoma
◆ Contact dermatitis is the most common stomal
complication, and leakage is reported as a cause
in 77% of cases
 References
• Bartle C, Darbyshire M, Gaynor P, Hassan C, Whitfield J, Gardiner A. Addressing common stoma complications.
Nurse Residential Care Journal. 2013. 15 (3), 128-33

• Beaver K, Latif S, Williamson S et al. An exploratory study of the follow-up care needs of patients treated for
colorectal cancer: Follow-up care needs of patients treated for colorectal cancer. J Clinical Nurs. 2010; 19(23–
24):3291–300. https://doi.org/10.1111/j.1365-2702.2010.03407.x

• Blakely, P. (2004). Practical stoma, wound, incontinence management. Research Publications, 2nd edn, Vermont,
Australia Boyd K. Innovations in care: managing severely excoriated peristomal skin using a hairdryer.
Gastrointest Nurs. 2014; 12(10):21–8. https://doi. org/10.12968/gasn.2014.12.10.21

• Boyles A. Stoma and peristomal complications: Predisposing factors and management. Gastrointest Nurs. 2010;
8(7):26–36. https://doi. org/10.12968/gasn.2010.8.7.78432

• Burch J. Care of patients with peristomal skin complications. Nurs Stand. 2014a; 28(37):51–7.
https://doi.org/10.7748/ns.28.37.51.e8317

• Burch J. Current nursing practice by hospital-based stoma specialist nurses. Br J Nurs. 2014b; 23(Sup5):S31–4.
https://doi.org/10.12968/ bjon.2014.23.sup5.s31

• Cutting K. Silicone and skin adhesive. J Community Nurs. 2006. 20 (11), 36-37

• Formijne Jonkers HA, Draaisma WA, Wexner SD et al. Evaluation and surgical treatment of rectal prolapse: an
international survey: Evaluation and surgical treatment of rectal prolapse. Colorectal Dis. 2013; 15(1):115–9.
https://doi.org/10.1111/j.1463-1318.2012.03135.x

• Gabe S. Fluid management. 2015. https://tinyurl.com/yb4npa46. (accessed 4 July 2018)

• Kelly O’Flynn S. Encouraging change: exploring perceptions of stoma care nurses on community stoma
care services. Gastrointest Nurs. 2015; 13(8):32–42. https://doi.org/10.12968/gasn.2015.13.8.32

• Kelly O’Flynn S. Protecting peristomal skin: a guide to conditions and treatments. Gastrointest Nurs.
2016. 14 (7), 19-22. https://doi.org/10.12968/ gasn.2016.14.7.14

• Kim J, Kumar R. Reoperate for stoma related complications surgery. Clinical Colorectal Surgery.
2006; 19 (4), 207-212. https://dx.doi. org/10.1055%2Fs-2006-956441

• Lawson A. Complications of stomas. Stoma care nursing. London: Hollister; 2003 Lee J, Moris O,
Stoma complications: a case of co-operation. Br J Community Nurs. 2003; 8 (7), 302-306.
https://doi.org/10.12968/ bjcn.2003.8.7.11558

• Pringle W, Swan E, Continuing care after discharge from hospital for stoma patients. Br J Nurs.
2001; 10 (19), 1275-1288. https://doi.org/10.12968/ bjon.2001.10.19.10000

• Rolstad B, Erwin-Toth, P Peristomal skin complications: prevention and management. Ostomy Wound
Manage. 2004. 50 (9), 68-77. https://doi. org/10.1111/ijd.13710

• Rudoni C. A service evaluation of the use of silicone based adhesive remover. Br J Nursing. 2008; 17
(2), S4-S9. https://doi.org/10.12968/ bjon.2008.17.Sup1.28143

• Taylor L. Peristomal sore skin: assessing the effect of an alginate wafer. Br J Nurs, 2012; 21 (16)
S41-46. https://doi.org/10.12968/bjon.2012.21. Sup16.S41

• Williams J, Gwilliam B, Sutherand N et al. Evaluating skin care problems in people with stomas. Br J
Nursing. 2010; 19 (17), S6-S15. https://doi. org/10.12968/bjon.2010.19.Sup7.78569
Thank’s For The
Attention