The easiest way to clean your stoma site is to gently wash it with warm water using the dry wipes provided and then pat dry thoroughly using a clean dry wipe. Avoid using paper towels as these can get stuck to the stoma, always use dry cotton wipes.
Small ulcerations can usually be treated with stoma powder or antimicrobial powder covered by a piece of hydrocolloid. A foam dressing over the ulceration is helpful if the ulcer is particularly moist.
To clean it, simply use tap water and soft medical wipes or soft cotton wool. The stoma and the skin around it doesn't need soap for cleansing, and in fact, soap could irritate it - as could baby wipes.
You may wish to apply a skin barrier cream to the sore skin before applying your stoma pouch. This will help soothe any irritated skin. iLex is an extremely popular cream that many ostomates swear by.
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).
Red or sore skin around your stoma is usually caused by leakage from your pouch and the output from your stoma getting underneath the appliance and onto your skin. It is important to regularly evaluate the skin around your stoma.
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.
A bulge in the skin around your stoma. Skin color changes from normal pink or red to pale, bluish purple, or black. A rash around the stoma that is red, or red with bumps – this may be due to a skin infection or sensitivity, or even leakage.
Prescription antibiotics that are used to treat the most common stoma infections are: A topical antibiotic such as fusidic acid. This is a cream that you will apply directly to the stoma. An oral antibiotic such as cephalexin.
Mucus-discharge is a common part of having any type of stoma. Mucus is produced by the lining of the bowel to help with the passage of stools. The lining of the bowel will continue to produce mucus after stoma surgery, even though it is not needed anymore.
To treat irritated skin around the stoma you can use stoma powder under the ostomy appliance. The powder is available from a medical surgical supplier. If skin has a red, raised, itchy pimply rash: If you have a rash this may indicate a yeast infection and you may use an antifungal powder (2% Miconazole).
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.
It involves washing out your colon with water either every day or every other day. To do this, you gently insert a small device into your stoma and attach it to a bag full of water. You slowly move water into your colon so it washes it out.
When the skin becomes infected it can start to look inflamed and the infection tends to cause some swelling around your stoma. The skin colour often changes from a healthy pink/reddish colour, to pale, bluish purple or even black. If there is any discharge of blood or pus this is often a definitive sign of infection.
Some common complications of stoma include poor siting, parastomal hernia (PH), prolapse, retraction, ischemia/necrosis, peristomal dermatologic problems, mucocutaneous separation, and pyoderma gangrenosum. Each will be discussed separately in further detail.
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.
Medications that may not be absorbed adequately include certain antimicrobial agents, digoxin, mesalazine, levothyroxine, and oral contraceptives. Enteric-coated or extended-release medications should be avoided by those with an ileostomy because the medication is absorbed or partially absorbed in the colon.
Ileostomy closure surgery is usually done through your stoma (see Figure 1). Your surgeon may need to make an additional incision (surgical cut), but this is rare. After your surgery, you'll have a small wound where your ileostomy used to be. This wound will heal in about 4 to 6 weeks.
It's especially important to keep the skin around your stoma—called peristomal skin—clean and healthy. This helps avoid irritation, infection and potential complications. You'll need to clean around your stoma whenever you change your pouch. The key is to be gentle.
When the skin around the stoma is very red and wet. There might even be blood and pain. This is due to irritated skin from feces or certain ostomy products like pastes or solvents. To avoid this, make sure to measure your stoma and cut your barrier to the correct size (1/8" bigger than the stoma).
The best way to clean the skin around your stoma is to use warm water and a washcloth, or soft paper towels. The use of gauze or gloves is not needed.
If the skin around the stoma does not appear to be similar to the skin on rest of your abdomen, it is likely that you have a skin issue that needs to be addressed. The skin barrier should protect your skin. If the skin is irritated (red, moist, or sore to the touch), the pouch seal can fail and leakage.
Signs of Stoma Problems
The stoma is no longer beefy red or pink but pale in appearance. The stoma is no longer moist in appearance but seems dry. Your stoma turns dark red, purple, or even black in color. Your stool from the stoma is always watery or diarrhea.
Depending on the severity of the prolapse, a referral can be made to the Surgeon for review, but is often not deemed as urgent, unless the prolapsed stoma changes to a very dark/dusky colour, stops functioning or causes pain. Pain may suggest bowel strangulation which is treated as an emergency.
Call your doctor or nurse advice line now or seek immediate medical care if: You have pain that does not get better after you take your pain medicine. You have signs of infection, such as: Increased pain, swelling, warmth, or redness.