colostomy types and nursing care, purpose and indication

AUTHOR : CHAITHRA SELVI GOPAL 

 
*Introduction


Colostomy


Colostomy is a surgical procedure that allows intestinal contents to pass from bowel through opening in the skin on the ostomy site.

*Definition 


A surgically created opening in the abdominal wall through which digested food passes

* TYPES
-Ascending 
-Indications for ascending colostomy 
-Transverse colostomy 
-sigmoid colostomy

*Ascending colostomy

Semi liquid stool consistency increased fluid requirements needs appliances and skin Barrie's cannot be irrigated

* Indications for ascending colostomy

Perforating diverticulitis in lower colon trauma inoperable tumors of colon rectum or pelvis, rectovagInal fistula

* Transverse colostomy

Semi Formed stool consistency possibly increased fluid requirement uncommon bowel regulations requires appliance and skin barrier cannot irrigate.

* Sigmoid colostomy

Formed stool consistency no Change in fluid requirements bowel regulations possible with irrigation and need for appliances for surgery

*PURPOSES

- To maintain integrity of stoma and persistent skin

-To prevent lesion ulceration

-To prevent from  infection

- To promote general comfort and positive self image

-To provide clean colostomy pouch for fecal evacuation

- Reduce odour from over use of old pouch

*INDICATIONS


- Gangrenous sigmoid volvulus 
- colorectal cancer 
- penetrating abdominal injury 
- Anorecatl cancer 
- intussusception 
-perinal injury

*CONTRAINDICATION

- Incipient cardiac failure and unstable angina 
- Respiratory dysfunction
- Bleeding disorder 
-kidney disease 
-Skin infection

* NURSING CARE OF COLOSTOMY


-Assessment of the stoma and provision of an appropriate  poaching system 
- providing  the skin care on stom site 
- protect the skin and contain drainage and order 
- educating about the stom and care to the patient and family 
-Teaching about the selecting  appropriate pouch and emptying 
- Teaching the complications about colostomy and pouch
- Emotional support to the patient 
- counselling regarding to enhance the body image 
-Demonstrating  the colostomy irrigation 
-Educating about the selecting appropriate food substance well balanced fluid intake 
-Explain the  important of follow up
- Routinely wash with warm water. Soap is used be sure to avoid ones with oils and rinse thoroughly

*COMPLICATIONS

- prolapse 
-Retraction 
-Fistula 
-stenosis 
-Herina

Colostomy – Types and Nursing Care