Stoma - what is it? Stoma of the intestine. Care of stoma

Modern medicine has a variety of means to save the patient's life. But till now in medical practice there are methods known still to ancient healers. One of these is a surgical procedure called stoma. What it is, what it says, how it's done, you'll find out about all this after reading the material. We also paid special attention to caring for different types of stoma, as often such manipulations are carried out at home, and the quality of their conduct influences the process of recovery.

The concept of stomirovanie in medicine

Stoma - what is it in surgery? This is a special opening, which is surgically manufactured by a patient for medical reasons. Most often, the stoma of the intestine, the bladder, and more rarely the trachea. What is an ostomy? This hole, which communicates a hollow, broken organ with an external catheter or tube to normalize the patient's condition after surgery or other manipulations. The most common operation is the formation of a hole in the abdominal cavity. In this case, the indication for stomy is the removal of the intestine (or part of it).

Stoma - is it temporary or for life, is this condition of a person considered a disability? An artificial hole is not considered a disease and in itself is not an excuse for getting a disability, since it does not exclude the possibility of a full life. Having learned how to properly use a kalopriemnik or other devices for caring for an ostomy, a person can fully work, study, play sports, build a family. But often it is the indications for stomy are a serious pathology, leading to disability and limited ability of the patient.

Stenting can be temporary, for example, such an operation is performed to rehabilitate a patient after a surgery or a serious infection that disrupts the work of the outflow system. After restoration of disturbed functions, the stoma can be removed surgically. But in some situations, for example, after removal of the intestine, the stoma is a necessary condition for ensuring the normal life of the patient.

Indications for ostomy

Indications for the operation of stomy are congenital pathologies, injuries, operations, which led to the complete or partial removal of the excretory organs. Accordingly, the normal operation of damaged systems is disrupted. Stoma helps restore the body's natural functions. In what cases does it become necessary to completely or partially remove the intestine, bladder or trachea, after which an artificial hole is required:

1. The first place is occupied by the cancer of these organs, which leads to surgical intervention to remove damaged tissues.
2. Injuries.
3. Nonspecific and ischemic colitis.
4. Incontinence.
5. Radiation and chemical damage.
6. Other diseases that disrupt the working capacity of organs.

There are different types, shapes and sizes of the stoma. What it is? The photo below shows an intestinal artificial fistula.

Types of stoma

Stomas are differentiated depending on the area of surgery:

• Gastrostomy;
• Intestinal: ileostomy, colostomy;
• Tracheostomy;
• Epicystostoma.

The shape is convex and drawn. There are single-barreled and double-barreled. Depending on the duration of the application: temporary and permanent.

According to statistics, most often other types of ostomy are found.

Each species differs in the principle of setting, mode of action and needs a certain care and rehabilitation period.

Tracheostoma: indications, features

Tracheostoma is an artificially created hole in the neck with a withdrawn tube, which is installed to recreate the damaged functions of human respiration. In the case of abnormalities in the respiratory system, the impossibility of producing an independent act of inhalation-exhalation, the patient often urgently stays a trachea.

Such an ostomy is a difficult education. It gives a lot of discomfort to a person. Especially if set forever. Open airways contribute to the easy penetration of viruses and bacteria, which leads to various diseases and weakens the overall immunity of a person. In addition, the artificial "trachea" does not moisturize or warm the inhaled air, which also contributes to the penetration of infections and the risk of developing various diseases. Therefore, it is necessary to control the quality of the inhaled air from the outside - carefully monitor the air temperature in the room in which the patient is. To moisturize, use special devices or apply a wet cloth to the surface of the tracheostomy tube, changing the tissue as it dries.

The patient can not engage in active sports, swim (especially underwater). Any, even insignificant water ingress into the tube can lead to a stoppage of breathing.

Tracheal stoma - is it forever? Most often not. It can be permanent only if the trachea is removed (which is very rare) or if the person is completely unable to breathe independently, when this condition is not subject to treatment and recovery.

Temporary tracheostomy is established during a surgical operation for anesthesia, if anesthesia is not possible in other ways.

Care of tracheostomy

Tracheostoma requires regular proper care:

1. Every few hours, the outer tube needs to be washed with a solution of sodium bicarbonate (4%) to remove mucus residues from the cavity.
2. To prevent the formation of skin inflammation and disease, it is necessary to treat a site around the tracheosome. To do this, in a bowl, wool balls are moistened with a solution of furacilin. Then, using tweezers, they dip a skin patch around the tracheostomy. Then zinc ointment or Lassar paste is applied . The treatment is completed by the imposition of sterile wipes. Fix the dressing bandage.
3. Periodically, it is recommended that the trachea contents be sucked, as often patients with a tracheostomy can not fully clear their throats, which leads to stagnation of the mucus and, as a result, difficulty breathing. To carry out such manipulation, you have to sit the patient on the bed and perform a manual massage of the chest. Through the tube, pour 1 ml of sodium bicarbonate (2%) into the trachea to dilute the mucus. Then you need to insert a tracheobronchial catheter into the tube. After attaching a special suction, remove the mucus from their trachea.

Proper care of the stoma is extremely important, as a violation of its functions can lead to a stop of breathing.

Gastrostoma

The gastrostoma is removed from the abdominal area to provide the human with food in cases where the patient can not eat on his own. Thus, liquid or semi-liquid nutrition is injected directly into the stomach. Most often, this condition is temporary, for example, with serious injuries and in the postoperative period. Therefore, the gastrostomy in rare cases is constant. When restoring the function of independent eating, gastrostomy is closed surgically.

How to properly care for gastrostomy?

Stomach stoma - what is it, in what cases is it established? When a gastrostomy is applied to the outside, a rubber tube is drawn out, intended directly for transporting food to the stomach. During feeding, insert the funnel for convenience, and in between meals, clamp the tube thread or clothespin.

With gastrostomy, the main purpose of care is to treat the skin around the hole in order to prevent skin inflammation, diaper rash, rash. The skin area around the stoma is treated first with a solution of furacilin using cotton balls and tweezers, and then with alcohol. Then it is lubricated with aseptic ointment. The procedure is completed by applying a bandage.

Epicystostoma: indications, care

Epicystoma is excreted from the bladder to the surface of the abdominal wall with a special catheter. Indications for the appointment of such manipulation is the patient's inability to natural urination for various reasons. Epicostostomes are temporary and permanent.

This stoma requires special observation. What does it mean? Care for epicystostoma is quite complicated: you need to be able not only to clean the catheter and take care of the skin around it, but also to wash the bladder and replace the urine collection. Therefore it is better if such procedures are performed by a qualified nurse or nurse.

Epicistoma makes certain restrictions in the life of the patient. So, the patient is not recommended to swim, play sports, stay in the low temperature for a long time.

Care must be taken to keep the catheter clean and the area of the skin around it. Twice a day, you should wash the skin with soap and water, and the outer tube and urine receiver - as the blockage occurs.

It is important to monitor the quantity and quality of the secretions. There should be no pus and blood - if you have such symptoms, you should urgently seek medical help. Also, specialist consultation is required in case of an increase in the patient's body temperature, a decrease in the volume of urine, a change in color, a catheter damage or a violation of its position, and the presence of pain in the lower abdomen.

Intestinal stoma: Species

Intestinal stoma - what is it, what kinds exist? This type of hole is also called an "artificial intestine". Established in case of violations of the work of the relevant body after various surgical operations. For example, when removing the intestine or part of it. In this case, a constant stoma is put. And, for example, after the operation of removing the hernia, which led to the inability of the body to cope with the excretion of stool in a natural way, surgeons spend time stamping.

Excretion on the abdominal wall of the large intestine is called a colostomy. A thin - Ileostomy. Outside, both species represent the intestinal portion of the intestine. Such an ostomy is a fistula in the form of a rose, on which the outside of the kalopriememnik.

In order to prevent postoperative complications and the spread of an unpleasant odor, the stoma of the intestine needs regular care.

How to care for intestinal stoma?

With intestinal stoma more often than with other types, there is a development of complications associated with improper care. Contrary to popular belief, the kalopriemniki need to be changed only as needed, as frequent changes lead to irritation and damage to the stoma and the area around the hole. Depending on the type of kalospriemnika change it should be with such regularity:

• When the contents of a single-component system reached half or the patient had discomfort from the bag-receiver;
• With a two-component system, the adhesive plate is left for 3 days.

Directly the bag for receiving stools is worn at the time of defecation. After that, immediately removed, the stomas of the intestines are cleaned with a soap solution, dryly wiped with napkins. Then lubricated with the drug "Stomagesive", and the intestinal mucosa - Vaseline to prevent cracks. A napkin folded in several layers is applied, a bandage is fixed with a band-aid, and then the underwear is put on. Caring for the stoma is an important part of the patient's recovery.

Complications

Complications after the operation of stomirovaniya - the situation is quite common. Stoma after surgery requires careful monitoring of the doctor and proper care. What problems may arise, how to deal with them and prevent them, let us consider in more detail:

1. Dermatitis peristomny (skin irritation). Irritation can occur due to improper care, improper means and preparations, improper strengthening of the catheter. There is burning, itching, rashes.
2. Bleeding from the area of the artificial hole may be caused by trauma to the mucous membrane by a catheter or tube. Usually, such injuries do not cause concern to doctors and pass on their own. But if the bleeding is profuse and does not stop within a few hours, urgent medical attention is needed.
3. Retraction (the stoma is drawn inward). This condition makes it difficult to use kalopriemnikov, outer parts of pipes and a catheter. Skin care also becomes complicated. Consultation of a specialist is necessary.
4. Stenosis (narrowing of the opening). If the stoma narrows to the point where its functions are violated (there is no fecal mass in the intestinal stoma or breathing is difficult with a tracheostomy), then surgical intervention is necessary. Narrowing of the hole occurs due to inflammatory processes.
5. The prolapse of the intestinal stoma by several centimeters does not violate its functions and does not affect the patient's condition. But there are cases of complete loss. Often this happens with increased physical exertion, coughing. Depending on the situation, the fallen stoma can be independently corrected. In case of frequent fallout, consult a doctor.

Stoma - this is not a disease, but, nevertheless, a person in this state needs careful attitude and care. Both temporary and permanent stoma require compliance with medical prescriptions. Choose the means of care recommended by a specialist for the type, shape and brand, as only the surgeon can determine which type of receiver and catheter, paste and ointment will be most effective and comfortable for the patient in a particular medical case. The choice takes into account the size and type of the hole, its purpose, type of skin, the patient's tendency to allergies and many other attendant factors. Do not self-medicate - strictly observe the appointment of a specialist.