After a urostomy, you’ll have to care for your stoma and the skin around it (called the peristomal skin). You must keep the stoma clean and protect the peristomal skin from moisture and urine.
This will prevent skin problems and odor. Check your stoma and the skin around it each time you change your pouch. Stand in front of a mirror, or use a hand mirror so that you can see the entire stoma. The stoma should look shiny, moist, and pink or red. The skin around it should be smooth, with no red or open areas. When you change your pouch, be sure to clean
the stoma and the skin around it. Do this using warm water and a soft washcloth. Water does not harm the stoma. Clean and dry the stoma gently. Because the stoma has no sensory nerves, you could injure it without feeling any pain. The stoma may bleed a little when you clean it. That’s because it has tiny blood vessels. To stop the bleeding quickly, apply gentle pressure to the stoma using a dry cloth or tissue. Be aware that urine will keep
flowing out as you clean your stoma. You can use a folded paper towel or piece of gauze to absorb the urine. For the pouch to stick well, the peristomal skin needs to be dry and smooth. If the skin is moist or uneven, the pouch is more likely to leak. And any urine that leaks out of the pouch can pool on your skin. This can irritate the skin. Urine that leaks from the pouch can also cause odor or be absorbed by your clothes. You can help
prevent these problems by following these steps: Be sure your skin is dry before applying the skin barrier. This helps keep the skin healthy. Always pat your skin dry after washing it. Or, try drying your skin with a hair dryer that’s set on cool.Checking the stoma
Cleaning the stoma
Protect the skin around the stoma
Try applying a skin barrier wipe before you put on a new pouch. This helps protect the skin if urine leaks around the pouch. A skin barrier wipe may shorten or lengthen the amount of time you can wear some pouches. Before using a wipe, check the product information that came with your pouch.
When to see your healthcare provider
Call your Wound Ostomy and Continence (WOC) nurse or other healthcare provider if:
The skin around the stoma is red, weepy, bleeding, or has open areas.
The skin around the stoma itches, burns, stings, or has white spots.
The stoma swells, changes color, or bleeds without stopping.
The stoma sinks below its normal level or below the skin.
The stoma sticks up above the skin more than normal.
- PMID: 3646664
Peristomal skin integrity
D C Broadwell. Nurs Clin North Am. 1987 Jun.
Abstract
The primary goal of skin care for the person with a stoma is prevention of skin breakdown. The first step is careful maintenance of the skin from the time of surgery forward. The patient and family should be taught every step of protecting the skin and recognizing early signs and symptoms of potential breakdown. The loss of peristomal skin integrity affects the person's entire well-being. Pouches will not adhere as well and accidental leaks occur. The impact on psychologic well-being is difficult to measure, but can be assumed to be significant. A circular effect can begin in which the skin irritation leads to accidents, which further compromise the skin integrity. Time may be lost from work or school. Damaged skin is also painful. The cost of treating peristomal skin breakdown can be high. The products used in ostomy care are relatively expensive. A single skin barrier may range from $3 to $5. Frequent changes will be necessary to assess and treat the lesions adding to the cost. Prevention is in the realm of effective nursing care and will include assessment of the skin, selection and application of appropriate pouches and skin barriers, patient and family teaching programs, and follow-up evaluations after hospitalization.
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