Sedigheh Aghaei BSN –ETN WOCN Infection Bleeding Stomal edema Excessive secretion Necrotic...
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Transcript of Sedigheh Aghaei BSN –ETN WOCN Infection Bleeding Stomal edema Excessive secretion Necrotic...
Sedigheh Aghaei
BSN –ETN
WOCN
Infection Bleeding Stomal edema Excessive secretion Necrotic stoma tissues Mucocutaneous separation
Cause:
•Deficient blood supply
Management:
•Observation
•Surgical revision
Stomal ulcer Stomal Retraction1.Stoma Prolepses Stomal Stenosis Stomal hernia
Prolapse Retraction Stenosis
Necrosis Herniation Phosphatic Deposits
Causes:
•Weakened abdominal muscles
•Inadequate surgical suturing
Management:
•proper stoma siting
•avoid lifting heavy objects
•Use flexible appliances
•surgery if blood supply impaired
Cause: Scar tissue
formation Stoma retractionManagement: Prevent
excoriation/scar formation
Dilatation Surgical
reconstruction
Causes: Weakened abdominal
muscles Oversized incision opening Heavy lifting Ascites Disruption of internal
attachments securing the bowel
Observe for color changes in stoma Reduce swelling Manual reduction before base plate Measure base of stoma Surgical correction
May occur immediately post-Op
Necrosis of stoma tissue
with scar Tension on the bowel the Weight gain cause fatty
tissues to bulge outwards around the stoma
complication of chemotherapy
Tight base plate most common cause
Causes :Tight base plate most common causeRad Cut base plate too fitManagement:Remove causeUse barrier wipeGet a good seal on the appliance & protect the skin Correct leakageCut base plate fit
Priostomal Skin Problems
Allergic skin reactions Contact Dermatitis Folliculitis Maceration Bacterial Infection Fungal Infection Candidacies
Allergic skin reactionsCauses:• Skin cleanser• Skin protector• Appliance & Dressings.• Tape • Radiotherapy• Poor hygiene
Priostomal Skin Problems
Causes :Long term ileostomateStoma output 600 ml daily of faecesSore skin for 2 weeksPoor stoma sitting
Causes: wafer opening too large improperly fitted skin barrier or poor adhesive Priostomal skin folds /creases leakage underneath wafer not attended to Priostomal skin not properly cleaned
Management: remove cause correct leakage Stomahesive powder Skin barrier
Cause: Removal of hair
from follicles by aggressive adhesives
Management: Shave Priostomal
hair Use barrier wipe Corticosteroid
spray
Cause: prolonged contact with
alkaline urine wafer used for too long opening too large
Management: Add 1-2 drops of vinegar
in cleansing fluid for cleansing
Increase fluid intake Vit C