Good care is necessary for avoiding skin injuries and infections.
KNOWLEDGE CENTRE
OSTOMY CARE
STOMA HYGIENE AND PERISTOMAL SKIN CARE
After ostomy it is necessary to establish a care routine for your stoma and peristomal skin. Although you are facing some new procedures that are yet to become your routine, your hygiene will not require significant and demanding changes. In order to facilitate the adoption of a new routine, it is good to familiarise yourself with the key elements of stoma hygiene and peristomal skin care.
CAUSES AND TREATMENT
If the contents of the ostomy bag come into contact with your skin, this may damage the skin. In order to avoid skin damage and minimise the risk of possible infections, you need to perform regular stoma care and keep the peristomal skin (part of the skin under your ostomy system) clean and dry.
In short, stoma hygiene and peristomal skin care preserve your health and have a positive impact on the quality of your life. In addition, a healthy peristomal skin is necessary for a practical reason —base plates adhere better to healthy skin.
When to empty/change the ostomy bag?
You replace closed bags with new ones when they are approximately 1/3 to 1/2 full. The drainable bags are emptied when 1/3 to 1/2 full, after which you continue to use them, and usually replace them with a new one after 2-3 days of use. Replacing and emptying the bags regularly is important in order to avoid accidents with the ostomy system.
When to perform stoma and peristomal skin care?
The care for your stoma and peristomal skin will usually be connected to changing your ostomy bag or system. How often you will change them depends on several factors, such as the type of your stoma, your ostomy system and the amount of content that your stoma produces.
You will determine how often you should change your ostomy system through consultation with your doctor and stoma nurse, but also through your own experience.
It is advisable to change the ostomy bag or system in the morning and before meals, when your stoma does not produce a lot of stool or urine. If you have an ileostomy, the change before meals is particularly important because the digested content will reach your stoma very quickly.
How to perform stoma and peristomal skin care?
- Wash your hands – clean hands are the foundation of good personal hygiene and therefore it is important to wash them before, but also after performing your stoma and peristomal skin care. If necessary, you can also use accessories such as sprays to facilitate the removal of glue.
- Slowly remove the base plate – when removing the base plate, do not make sudden movements, but do it slowly and gently to avoid skin damage.
- Use warm water – after removing the system, wash the stoma and peristomal skin with warm water and gently remove the remains of the paste with a towel, if you use it. If you have not removed the base plate (in two-piece systems), you can still use water to clean the skin because it will not affect the base plate adhesive.
- Treat your stoma gently – there are no nerve endings in the stoma and you won’t feel it when you touch it. However, the stoma is delicate and therefore you need to treat it gently.
- Avoid contact of skin with faeces and urine – faeces can irritate your skin. Digested ileostomy content especially can severely irritate and damage the skin.
- Wash your skin and stoma well – it is important not to leave traces of soap or other agent you used to wash it because it can affect the adhesion of the base plate.
- Dry the skin thoroughly — you can use an ordinary clean towel. It is important that the skin is completely dry before applying a new system in order for the base plate to adhere to the skin well.
- Remove the hair — if you have hair in the peristomal area, it is important that you regularly remove it for a better adhesion of the base plate.
What should you avoid?
When washing the skin, avoid aggressive soaps and agents containing alcohol as they can irritate the skin. Also avoid products containing oil because they make it harder for the base plate to adhere to your skin.
What should the peristomal skin look like?
Peristomal skin should look like the rest of your skin on the abdomen. Check it daily and if you notice any changes such as redness or rash, consult a doctor.
What if the stoma bleeds when performing peristomal skin care?
Since it contains many blood vessels, the occurrence of minor bleeding is not unusual. However, if the bleeding is abundant, does not stop or comes from the inside of the stoma, you should contact your doctor immediately.
How to shower and bathe with a stoma?
Unless your doctor or nurse advised you otherwise, you can bathe or shower every day in the usual way with or without a stoma system. Water will not harm your stoma or your ostomy system, and the base plate adhesive is waterproof. When bathing or showering without a system, you can use a stoma zipper instead.
If you have an ileostomy, you can take a shower without an ostomybag, but it is advisable that you have it on when you bathe.
Make sure that the water is not too warm or hot to avoid getting hurt. In the end, it is important that you thoroughly wash the agent you used and dry the skin, your stoma and ostomy system well with a towel.