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colostomies

Posted

Specializes in Med/Surg, Home Health.

I am not good at applying the colostomy system. I put one on, it comes off within a couple hours. I had a patient yesterday who had a new colostomy and it was producing LARGE amounts of liquid stool. I had a very hard time with it, it kept leaking. I would put one on, later it would start leaking. I cleansed it, allowed it to dry, applied skin prep, paste, then placed the flange and bag. I dont know what Im doing wrong. Any advice? PLEASE!

Is the hole trimmed properly to the stoma size and shape? Pay close attention to the shape, it can make a big difference.

Elektra6, ASN, BSN, RN

Specializes in Home Health, LTC, subacute. Has 16 years experience.

In my LTC, I took care of a lady with an ileostomy. It was a nightmare for her and us with the leaks but I did learn a few tricks. What worked for me is to cut some Duoderm or Exoderm into strips then use them to reinforce the edges. This should definately help with a regular colostomy. With an ileostomy or loose stools you will get leakage no matter what, but this should buy you time. You will notice a SMALL leak and have time to change vs having a large leak and having to change bedding and clothing.

NewRN2008, ASN, RN

Specializes in Ortho; Gyn; Urology; HBOT; Emergent. Has 8 years experience.

see if you have a wound or colostomy nurse..watch a few times for a review. heck, have them watch you do one, may be a little hard on the ego, but you would learn!!

gl!

hth

-H-

I would agree with a previous poster-- if you have a WOC nurse (wound, ostomy, continence) nurse on staff, ask that person to help you.

If it is an ileostomy (usually on the right lower quadrant), they can be tricky, due to the liquid effluent. Also, if a new ileostomy, it takes a while for the effluent to get a little thicker (it still won't be formed).

Some folks may look like they have a flat pouching surface, but then then move around, and a crease or pucker may develop on the abdomen that wasn't there when you were pouching, and voila! it starts to leak.

Your WOC nurse should have a variety of barriers and pouches to help figure out what works. The patient may need a convex system with an ostomy belt, or a flexible system, or different adhesive. There are many combinations of products that can be used.

Good luck to you. It sounds like you are doing it rights, but it is probably a challenging patient.

Oldiebutgoodie

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