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Sedigheh Aghaei
BSN –ETN
WOCN
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Infection Bleeding Stomal edema Excessive secretion Necrotic stoma tissues Mucocutaneous separation
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Cause:
•Deficient blood supply
Management:
•Observation
•Surgical revision
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Stomal ulcer Stomal Retraction1.Stoma Prolepses Stomal Stenosis Stomal hernia
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Prolapse Retraction Stenosis
Necrosis Herniation Phosphatic Deposits
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Causes:
•Weakened abdominal muscles
•Inadequate surgical suturing
Management:
•proper stoma siting
•avoid lifting heavy objects
•Use flexible appliances
•surgery if blood supply impaired
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Cause: Scar tissue
formation Stoma retractionManagement: Prevent
excoriation/scar formation
Dilatation Surgical
reconstruction
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Causes: Weakened abdominal
muscles Oversized incision opening Heavy lifting Ascites Disruption of internal
attachments securing the bowel
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Observe for color changes in stoma Reduce swelling Manual reduction before base plate Measure base of stoma Surgical correction
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May occur immediately post-Op
Necrosis of stoma tissue
with scar Tension on the bowel the Weight gain cause fatty
tissues to bulge outwards around the stoma
complication of chemotherapy
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Tight base plate most common cause
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Causes :Tight base plate most common causeRad Cut base plate too fitManagement:Remove causeUse barrier wipeGet a good seal on the appliance & protect the skin Correct leakageCut base plate fit
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Priostomal Skin Problems
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Allergic skin reactions Contact Dermatitis Folliculitis Maceration Bacterial Infection Fungal Infection Candidacies
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Allergic skin reactionsCauses:• Skin cleanser• Skin protector• Appliance & Dressings.• Tape • Radiotherapy• Poor hygiene
Priostomal Skin Problems
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Causes :Long term ileostomateStoma output 600 ml daily of faecesSore skin for 2 weeksPoor stoma sitting
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Causes: wafer opening too large improperly fitted skin barrier or poor adhesive Priostomal skin folds /creases leakage underneath wafer not attended to Priostomal skin not properly cleaned
Management: remove cause correct leakage Stomahesive powder Skin barrier
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Cause: Removal of hair
from follicles by aggressive adhesives
Management: Shave Priostomal
hair Use barrier wipe Corticosteroid
spray
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Cause: prolonged contact with
alkaline urine wafer used for too long opening too large
Management: Add 1-2 drops of vinegar
in cleansing fluid for cleansing
Increase fluid intake Vit C
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