Stoma complications can occur at some point after surgery in some patients. It is the job of nurses to assess the problem quickly, provide an effective solution, and refer the patient to the doctor if necessary.
According to a survey conducted in the year 2002, about 73% of people with a stoma have face skin problems, and about 66% of them try to resolve those problems without consulting to a nurse. Nurse involvement gets necessary in a situation where a patient doesn’t seek help.
Assessment
The job of the nurse is to carry out a detailed assessment before treating the problem. This assessment includes checking symptoms and observing the stoma and the peristomal skin. They also need to get information about how long the problem has been there and any treatments tried in the past. If the problem is not resolvable at the moment, they should refer the patient to the doctor.
Sore skin
One of the most common problems that occur with a stoma is skin soreness. Its symptoms mainly include red skin, which is usually intact. The worsening of this problem can lead to the breakdown of skin, causing skin ulcers. Before starting the treatment, the nurse has to assess the real cause of the problem. The most common reason for skin redness is the skin’s contact with the stomal output.
Another reason for the sore skin is the frequent removal of the skin barrier. This frequent pulling of the skin barrier can cause discomfort to the peristomal skin.
If you have a colostomy, but you have frequent stools, you may want to use a two-piece ostomy pouching system to avoid changing too many skin barriers during a specific period.
Difficulty removing the ostomy appliance
Some people find it difficult to remove the ostomy appliance, resulting in them pulling the skin barrier too hard. It can cause skin stripping, which can be quite painful. Nurses should teach such patients to be gentle with the removal of the skin barrier. Using adhesive remover sprays or wipes can make the removal of the ostomy skin barrier easier. The adhesive remover is particularly useful when the patient has to get rid of the residue left after the removal of a skin barrier.
Appliance leaks
A survey report suggests that about 85% of the patients with ostomies face the problem of leakage. There can be several reasons that can lead to the leakage of a stoma appliance. The most common reason is the ostomy appliance getting too full before the patient replaces or empties it. Teaching patients to change or empty the ostomy appliance when necessary can rectify this issue.
The stoma output that is too watery can leak under the skin barrier. If the problem has been persistent for some time, you may want to give the patient stool thickening medication. A dietary change may also serve the purpose.
The unevenness of the peristomal skin is also the reason for the leakage to occur. The skin barrier fails to form a proper seal with the skin in this regard. Using a stoma seal may help prevent leakage. Another way is to use a convex skin barrier, which has the protruded side that goes against the skin.
