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Stoma care: procedures, appliances and nursing considerations

10 December 2020
Volume 29 · Issue 22

Abstract

Several diseases and operations may necessitate the need for the formation of a stoma. Patients who are affected may be concerned about the effect of the stoma on their ability to carry out activities of daily living, as well as how it will affect their quality of life. Nurses who may be involved in the care of patients with a stoma should have an understanding of the reasons for stoma formation, and the types of stoma and appliances available, to enable them educate and support patients, and to allay any concerns.

There are about 120 000 people living with a stoma in the UK, with about 25 000 new stoma operations (ostomies) taking place each year. In 2017, there were about 11000 new colostomies, 9000 new ileostomies and 1660 new ileal conduits created (Lister et al, 2020). The most common underlying conditions resulting in the need for stoma surgery are listed in Box 1.

Major causes:

Other causes for stoma surgery include:

A stoma, which it is an artificial opening on the abdomen to divert flow of faeces or urine into an external pouch that is located outside of the body, can be temporary or permanent. Colostomy and ileostomy are the most common forms of stoma (Figure 1), but a gastrostomy, jejunostomy, duodenostomy or caecostomy may also be performed. Understanding the type and extent of surgical intervention in each patient is crucial in managing the patient's nursing needs correctly. It is important to recognise that, once a stoma has been formed, the patient (ostomate) will require an appliance that attaches to the abdomen to collect and dispose of the elimination products.

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