Secretions coming out of stoma-Best way to keep surrounding area clean

[whichone'spink, BSN, RN]

I have a patient who recently got his trach changed out to a smaller trach. Unfortunately, the previous trach was quite large and as a result, the stoma is bigger than the new trach. Secretions come out of the stoma, and I mean large amounts of it. Keeping the surrounding area clean and dry is a challenge. What can I do to keep the stoma area clean and dry, at least until it heals up?

[mallfreak34]

cleanse with peroxide and H2O. Nystatin ointment around stoma. Apply 1 or 2 drain sponges. Change as necessary.

[Silverdragon102, BSN]

Remember some things will require a physician order so be sure to go through the patient's PCP. May be worth asking other nurses in your area what suggestions they have and I am sure your RT team will have some suggestions as well as suport

[NRSKarenRN, BSN, RN]

I've found it best to clean irritated skin around trach stoma with just plain NSS as least irritating--only used dab of h2o2 if built up dried mucous. Fan area dry with clean dressing package (gets air moving to dry area quicker) then apply moisture barrier ointment/no sting wipes to protect skin around stoma from drainage. When precut trach dressing was thin gauze, would change to thicker type with smoother surface (forget name). Heavier exudate would use absorbant foam dressing used for skin ulcers.

Nystain is only used when fungal infection noted and requires RX.