COLOSTOMY

 COLOSTOMY

Definition:- Artificial opening of the colon (large intestine) through the anterior abdominal wall.

Purpose:- escape the flatus and stool.

Indication:-

1.Intestinal Obstruction.

2.Rectal Tumor and cancer.

3.Intestinal Cancer.

4. Imperforate of anus

Classification:-

According to Placement:-

1.Wet Colostomy 

2.Dry Colostomy

Wet Colostomy:- 

• stool is passed out in liquid form by the client.
• Incision is making in ascending colon.
• ascending wet colostomy is performing for short term/Temporary.
• Time:- 6-8 weeks.
• Opening :-opening of colostomy on the right side of abdomen .

Dry Colostomy.

• Incision is making in sigmoid colon.
• Stool is passing out in normal form.
• sigmoid colostomy is performing for long time or permanent based.
• Opening:- end colostomy or left side of abdominal.

Procedure:-

• nurse role before procedure precaution.
• stop the high fiber diet before 2-3 day from procedure.
• doctor explain procedure.
• doctor collect consent.
• collect investigation and report of patient.
• NBM 8-12 hours before colostomy to prevent risk of aspiration.
• prepare part.
• best time for part preparation(before 30 minute form the surgery)
• Site prepare:- just below the nipple to mid thigh.
• Solution:- 7.5% betadine or 7.5% savlon.

Position:-

• 1.Supine position:-during general anesthesia use in surgery
• 2. Trendelenburg:-when spinal anesthesia use during surgery.

Care of colostomy:-

• Check the vital sign.
• Provide side line or lateral position.
• Clean the outer site of stoma with betadine gauze then use dry gauze.
• Advantage:-prevent the growth of bacteria and microorganism.
• prevent skin irritation due to stool and HCL produce irritation.
• maintain soft dry to the stoma.
• cover to the stoma with a water  patch.

Advantage:-

• to prevent leakage of stool.
• water should be use/cut 1/8 inch more diameter than stoma.
• connect colostomy bag with ring of water.
• provide psychological support due to disturbed body image of client.

observe form stool:-

1. Ascending colon:-Liquid
2. Transverse:- Semi solid
3. Sigmoid:-Normal

Observe the color of stoma:-

• Bright red or pink:-Normal finding.
• Pale Pink:-Normal in anemic patient.
• Black or dusky:-abnormal finding due to compromised of blood circulation.(inform to doctor)
• Malodorous/foul smell form stoma upto  72 hr. after colostomy is normal finding.
• foul smell form stoma after 72 hr. due to infection then nurse inform to doctor.
• colostomy bag empty when fill upto 1/3 lelvel.
• change the water and colostomy bag in 72 hrs in or 3 days.