About

Complications can arise in the stoma or the skin around it at some point. That’s where the role of nurses becomes vital as they have to provide quick assessment, advice, and referral to treat the problem.

About 73% of people with a stoma face peristomal skin issues and two-third of those people try to find fixes without referring to a stoma care nurse. Nurses must offer help when patients do not seek assistance.

Patients must know how to use ostomy appliances to manage their stomal output, which can be in the form of either feces and flatus or urine. Closed appliances are mostly used for colostomies, while drainable bags are suitable for ileostomies and urostomies.

In this article, we will talk about the most common stoma complications in which nursing intervention may become necessary.

Assessment

Assessment is the key to figure out the right treatment. It includes assessing symptoms by observing the stoma and the skin around it. The nurses have to see how long the problem has existed, and what treatment had been considered in the past. If the problem cannot be treated quickly, nurses should refer the patient to a doctor.

 

Sore skin

Soreness in the peristomal skin is one of the most common stoma-related complications. Its symptoms mainly include red skin, which is generally intact. The skin tissue starts breaking as the problem worsens, leading to ulcers or erosions. It is necessary to assess the reasons of soreness before beginning the treatment.

In most cases, the soreness is due to the use of the wrong-sized flange. A flange with a too wide opening exposes a part of the peristomal skin to the stoma output. The best way to treat this issue is to understand what skin products may help to reverse the damage, and to teach the patient how to create a flange opening of an appropriate size.

Difficulty removing appliance

If the skin soreness is due to the rough removal of the ostomy appliance, you will need to educate your patient to be gentle with the process. Some people find it difficult to remove the ostomy appliance, so they pull it hard, which results in the skin stripping. You can teach them to remove the ostomy appliance gently. If it is not possible, you can train them to use adhesive remover. An adhesive remover is also beneficial for the removal of residue left over after the removal of the previous appliance.

Appliance leak

A 2010 study shows that around 85% of people with a stoma face the problem of appliance leakage. The top reason for an appliance leakage is it becoming overfull, which can increase the overall weight of the appliance, putting a strain on the skin barrier. Loose stool is another reason for the leakage. In that case, making dietary changes to thicken feces may be helpful. Reducing the fiber content of food may also be helpful. Sometimes, the unevenness of the peristomal skin may also be the reason for the leakage to occur. Using a stoma seal, also known as a washer or ring, may overcome the risk of leakage.