Stominated patients: what is it? Features of care for ostomy patients. What is a ostomy patient?

According to medical statistics, in Russia there are not one ten thousand people who belong to the category of "ostomy patients". Who is it? These are patients who, after surgical intervention on the front wall of the abdominal region, withdrew a ureter or gut. Formed as a result of the operation, this hole is called "stoma". This word has Greek roots. His translation sounds like "mouth" or "hole".

Need for an operation

The purpose of the stoma is in the drainage of urine or feces. The need for this opening occurs when the bladder or intestine is unable to function independently. There are various reasons for this state. This can be both an inborn defect, and a trauma or disease of the organ.

Of course, certain life difficulties are experienced by ostomy patients. What is this - existence in the absence of a closure device, which is observed in such patients? It is impossible to control the process of emptying the bladder or intestine. This situation makes it very difficult to communicate with people and conduct an active lifestyle.

Types of stoma

The hole that is projected onto the anterior wall of the abdominal cavity can be either permanent or temporary. In the first case, an ostomy patient can not perform an operation in the future that would eliminate their condition. The blocking apparatus of the bladder or intestine in such patients has irreversible damage. There is also no possibility of prompt restoration of intestinal patency.

The stool for removing stools is often called unnatural anus. In this case, there is the following classification of such holes:
- colostomy (when the colon is withdrawn);
- ileostomy (excretion of the small intestine);
- single-barreled (with the withdrawal of one trunk of the intestine);
- double-barreled (when on the abdominal wall there are two openings with the extracted intestinal ceca).

Means for care of stoma

The removal of the intestine or ureter on the abdominal region saves the patient life. If the doctor decides to perform the operation, then there is simply no other way out for the patient. Nursing care for ostomy patients requires the implementation of not complicated, but very responsible operations. First of all, they concern the processing of an artificially created hole. And for this there are special means, the choice of which will depend on the location and type of stoma. Consideration should also be given to the formation of the stool and the patient's preferences.
To date, manufacturers are offering two types of tools with which to effectively carry out ostomy patients. These are produced on an adhesive basis one- and two-component kalopriemniki, as well as uropriemniki.

What are these funds? One-component uro-and kalopriemniki are plastic bags having an adhesive basis. They can be closed (not drained) and open (drained). The second type of facility is distinguished by the presence of communication with the environment.

As for two-component receivers, they have two parts. One of them is an adhesive plate, and the other is a bag.

There are certain features of care for ostomy patients in the case of a retracted shape of the outlet. Such patients need to purchase special adhesive plates of the convection type. Their peculiarity consists in equipping with a rigid flange. They also have special "ears". These devices serve to attach the belt, which must be worn to secure the plate firmly.
A stooped patient with a colostomy can use both single- and two-component receivers. However, it should be borne in mind that this is possible only in the case when the chair is completely decorated, and the emptying of the intestine occurs 2-3 times during the day.

If a closed-type kalos tray is used, the bags in them must be changed up to three times a day, and the plate one or two times a week.

In the event that the patient has a propensity for diarrhea, then for him to acquire funds of an open type. The same receivers are also needed for those patients in whom ileostoma is excreted. These funds are changed less often than closed ones, no more often than once during the day. If the bag does not leak anywhere, the drained receivers can remain on the skin for up to three days, provided they are continuously emptied.

Preparation for care

Rehabilitation of ostomy patients should take place in parallel with their training. During this period, the patient is taught the rules of care for the stoma. In the future this will allow a person not to experience dependence in the issue of personal hygiene of an artificially created hole.

The person who cares for such a patient will need to make a small dressing table. This is an important kit, which is used by all the hundred-sick patients. What it is? These are such items as:
- scissors (preferably with blunt curved ends);
- a mirror;
- Hand soap;
- polyethylene bag for disposal of receivers;
- gauze, bandage, soft napkins;
- uro- and kalopriemniki;
- a soft towel.

If during the procedure the patient will lie, then it is necessary to lay a waterproof diaper under it . Independent change of the receiver is carried out in an upright position. For the convenience of the procedure in this case, you need a mirror.

Change of uro-and kalopriememnikov should be carried out before a breakfast or in the evening before a dream. After eating, this procedure is not recommended.

Care of stoma

As well as any other, this hygienic procedure requires preliminary washing of hands. It is mandatory to use soap. This also needs to be washed beforehand. However, you do not need to use soap. One warm water is enough. The skin near the hole can be simply treated with a special cleaner. However, it is worth remembering that it is forbidden to clean the stoma with liquids containing alcohol, antiseptic solutions, and ether. All these products, as well as soap, will dry the skin and remove the natural protective barrier from it. This increases the risk of mechanical damage to the treated area, as well as the likelihood of penetration into the body of pathogens.

After finishing washing, the skin should be dried. To do this, apply a gauze or a soft towel. In the absence of a constant allocation of fecal matter, the skin should preferably be dried in the air naturally.
On the abdomen around the stoma, hair follicles may be present. It must be removed with scissors. Use a razor or creams-depilatory is prohibited. These funds will cause irritation of the skin.

Installation of calories and urinals

When using one-component bags, you should immediately tackle the adhesive plate. It is preheated in the hands, removed from the protective coating and glued to the area of the stoma in the direction from the bottom up.
The two-component receivers are somewhat different. On the colostomy, a plate is glued, and then a bag is put on its flange. About its correct fixation is evidence of a click. Then the bag turns into a position convenient for the patient, and the fastening ring is closed on it. After snapping the latch, one more light click should be heard.

Removal of calories and urinals

In the case of using two-component agents, you need to remove the bag located on the plate. To do this, after pressing a finger on the latch, open the fastening ring and pull the receiver's ear upwards and slightly away from itself. The plate must be retained in order to avoid its peeling off.

Single-component receivers are removed together with the plate. To do this, one hand takes the bag, and the second hold the skin. Unstick such a receiver carefully, avoiding jerks.

Skin care around the stoma

The zone that surrounds the hole for the removal of urine or feces requires a vigilant attention. The patient should monitor its condition, as well as a specialist.

The skin in the area of the hole must be clean, dry and undamaged. In order to preserve her health, certain rules should be followed by ostomy patients. What is this for recommendations? In their list:
- selection of the right type of calorie or urine receiver;
- regular emptying and changing bags;
- elimination of the possibility of urine or feces entering the plate;
- immediate consultation with a specialist in case of appearance of reddening of the skin or the appearance of vesicles and sores on them;
- the use of special gels and creams to care for the area around the stoma;
- compliance with the diet and fluid intake;
- constant monitoring of the tightness of the abutment of the plate.

Elimination of gastrointestinal problems

As necessary, treatment of gas emission in ostomy patients is performed. Flatulence, which causes an increase in intra-abdominal pressure, is eliminated after the use of enzyme medications such as "Festal", "Panzinorm", etc. The course of treatment leads to the normalization of the intestinal microflora.

When constipation occurs, ostomy patients should also be alerted. What is it is known to everyone. However, patients with stoma especially need to eliminate this phenomenon, which provokes, among other things, the loss of small pieces of intestine. To do this, it is recommended to increase the fluid intake to two liters per day. You need to change the nutrition of the ostomy patients. In the menu you will need to include the maximum amount of foods rich in fiber. In this case, the high physical activity of the patient is also important. Cures can be cured with the help of enemas in the stoma area, as well as oral laxatives.

Psychological support

Some patients experience a great aversion to their stoma. They either defiantly do not pay attention to it, or behave very aggressively at the mention of the existing problem. It is desirable for such people to seek help from a psychologist or a psychotherapist. It is also important to explain to the patient about the vital necessity of imposing a stoma and undesirability of a fastidious attitude towards it.

The problem for women

A stooped patient often asks about the possibility of becoming pregnant and having a baby. Obstacles for this do not exist. The main thing is that during the operation the ovaries and uterus are not affected.

An Important Moment

Having decided to have a baby, the ostomy patient must consult the surgeon who treats her. Such an important life step can be made only after the approval of a specialist. The entire period of pregnancy in these patients occurs without any complications. Safely and in due time pass and childbirth. Only they, as a rule, are carried out with the help of caesarean section.

Purchase of special linen

Of course, ostomy patients have their own characteristics. In this regard, they need to wear special underwear. It is sewn with an inner pocket in which a calorie or urine receiver is placed. This gives additional confidence to the patient. The plate on his skin will remain sealed and will not depart under the weight of the filling bag.

Linen for ostomy patients will also preserve the health of the area around the hole in the abdomen. The fact is that the bag placed in the pocket will not rub the skin, since with it it will have no contact at all. A person wearing such underwear, calmly, without any discomfort, can change clothes in the dressing room and in the dressing room. The presence of the bag will not be noticed by anyone, since the weight of the receiver will be completely distributed along the entire abdomen. As for outerwear, there are no restrictions for ostomy patients. They can wear the same things that they had before surgery. The main thing is that the items of the wardrobe are not too tight.