Clean around your trach tube or stoma with cotton-tipped swabs using mild soap and water or saline (if you have no soap and water). You can also use a washcloth. Make sure your washcloth is clean and that you can reach under the faceplate of the trach tube, if you have one.
Mucus can dry and form a crust around the trach tube. If left for even a short time, it will have a foul smell. Also, if the stoma is infected, germs can get into the lungs and cause a lung infection. It is important to clean the stoma at least 2 times a day.
In general, if you have a colostomy you will change your closed bag one to two times a day and if you have an ileostomy or a urostomy, you will need to empty your bag several times a day and change your bag every three to five days depending on the wear.
They may recommend normal saline solution or a mixture of equal parts normal saline and hydrogen peroxide. The normal saline and hydrogen peroxide mixture is used to clean tracheostomy equipment.
Until your airway is well healed and you are used to breathing dry air, use a saline spray to keep your stoma moist. Use the spray, 1 to 3 sprays into your stoma, every 2-3 hours to keep your airway clean and moist.
Skin care around your stoma
Your stoma nurse or ENT surgeon may suggest sterile water, sterile salt solution or a mild antiseptic. Your stoma might need cleaning 4 or 5 times a day until it has completely healed. Keeping your stoma clean can help to stop scar tissue from forming.
You can bathe and shower as normal with your stoma and, unless you have been specifically advised otherwise, you can do so with the stoma bag on or off. It won't fall off in the water if you choose to keep it on and if you bathe with the stoma bag off, soap rinsing over the stoma isn't a problem.
For those that prefer to use soap to clean around the stoma, it's best to use a very mild soap. Avoid using soaps and cleansers with oils, perfumes or deodorants since these can sometimes cause skin problems or prevent your skin barrier from sticking. Rinse the soap off the skin around your stoma very well.
Cleanliness is one of the most important aspects when adjusting to life with a stoma. Once you've pushed the stool into the toilet, take some toilet paper and clean the inside and outside of the opening. Flushable wipes are very good to use in this instance, as they'll help eliminate any unsightly odor.
Cleaning your trach tube is important for these reasons: Regular cleaning prevents skin irritation that can lead to infection around the stoma site. It reduces the risk for respiratory infections. Cleaning prevents buildup of dried secretions that can block the tracheostomy tube.
Suction for 5 to 10 seconds or as long as directed by your healthcare provider. Don't keep the catheter in your trachea for longer than 10 seconds. Keeping it in too long can cause shortness of breath. Using a rotating motion, slowly pull the suction catheter out of your stoma.
Trach/Stoma Site Care
Clean around your trach tube or stoma with cotton-tipped swabs using mild soap and water or saline (if you have no soap and water). You can also use a washcloth. Make sure your washcloth is clean and that you can reach under the faceplate of the trach tube, if you have one.
Cleaning a tracheostomy tube. Plastic and metal tubes may be cleaned with mild soap and clean tap water. Hydrogen peroxide may be used to clean plastic or stainless steel tubes.
Stomal site care
The stomal wound should always be kept clean and dry. The stoma should be cleaned using sterile water or normal saline. If dried secretions are present, cotton-tipped swabs or gauze pads with sterile saline or water can be used to gently remove them.
Dampen a gauze pad or cotton-tipped swab and squeeze out any excess liquid from the gauze. Clean and remove dried mucus around the stoma with the damp gauze pad or cotton-tipped swabs. To prevent spreading an infection, wipe the gauze or swab only once and then throw it away.
Use only plain, lukewarm water and dry wipes for cleaning your stoma (if you must use wet wipes, then make sure they are free from lanolin and fragrance as the skin around your stoma can be very sensitive).
The first sign of a stoma infection may be a pus-like discharge, unusual swelling, increasing redness, or color changes. Some may notice an abscess or an ulcer. A Wound, Ostomy, and Continence Nurse (WOCN) or your doctor will be the best source for medical advice on this issue.
To clean the skin around the stoma, just use water on soft paper towels. Do not use baby wipes, oils, powders, ointments, or lotions on the skin around the stoma unless directed to do so.
Many people enjoy leaving their skin uncovered for 15 to 30 minutes after taking their pouching system off. This is called a skin break. Taking a skin break can help with irritation or keep it from happening. You can decide if you want to take a skin break.
You can swim or be in the water while wearing your pouching system. Remember, your pouching system is water-resistant and is designed not to leak with the proper seal. Water will not harm or enter your stoma.
Colostomy irrigation involves instillation of 500 – 1500 ml of tap water into the colon via the stoma to wash out fecal material. This is generally carried out daily or every 2 to 3 days, and results in little or no stool evacuation from the stoma until the next irrigation (Varma, 2009).
When you irrigate your colostomy, you're putting water through your stoma into your large bowel (colon). This allows you to empty your bowel. Irrigating your colostomy at the same time every day will help train your bowel to function on a regular schedule. This may allow you to stay free of drainage for 24 to 48 hours.