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Sedigheh Aghaei
BSN –ETN
WOCN
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Infection
Bleeding
Stomal edema
Excessive secretion
Necrotic stoma tissues
Mucocutaneous separation
Cause:
•Deficient blood supply
Management:
•Observation
•Surgical revision
Stomal ulcer
 Stomal Retraction
1. Stoma Prolepses
 Stomal Stenosis
 Stomal hernia
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Prolapse
Retraction
Stenosis
Necrosis
Herniation
Phosphatic Deposits
Causes:
•Weakened abdominal muscles
•Inadequate surgical suturing
Management:
•proper stoma siting
•avoid lifting heavy objects
•Use flexible appliances
•surgery if blood supply impaired
Cause:
 Scar tissue formation
 Stoma retraction
Management:
 Prevent
excoriation/scar
formation
 Dilatation
 Surgical
reconstruction
Causes:
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Weakened abdominal
muscles
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Oversized incision opening
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Heavy lifting
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Ascites
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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
May occur immediately
post-Op
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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
Tight base plate most common cause
Causes :
Tight base plate most common cause
 Rad
 Cut base plate too fit
Management:
 Remove cause
 Use barrier wipe
 Get a good seal on the appliance
& protect the skin
 Correct leakage
 Cut 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
Priostomal Skin Problems
Allergic skin reactions
Causes:
• Skin cleanser
• Skin protector
• Appliance & Dressings.
• Tape
• Radiotherapy
• Poor hygiene
Causes :
 Long term
ileostomate
 Stoma output
600 ml daily of
faeces
 Sore skin for 2
weeks
 Poor stoma
sitting
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
Cause:
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Removal of hair
from follicles by
aggressive
adhesives
Management:
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Shave Priostomal
hair
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Use barrier wipe
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Corticosteroid spray
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