Guidelines for the person with permanent ostomy

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We can consider the ostomy, a procedure that generates psychic vulnerability for those who need it. The ostomy diverts the flow of feces to an opening, necessarily surgically provoked in the abdomen, which we call “stoma”. The procedure is performed out of clinical necessity, where a removable bag is placed in place to collect the flow of stool. The bag should be sanitized throughout the day and replaced when necessary. The bag is needed 24 hours a day, since it is not possible to control the intestinal flow. Its indication can be diverse, but most of the time it is about infections, inflammations, puncture injuries, wounds, blockages or cancers.

The condition can be temporary or permanent. When we have a permanent condition, ostomy will happen when parts of the rectum, anus and colon need to be removed due to illness or treatment of an illness. A colostomy or ileostomy will usually be performed. The procedures cause the need to readap patients to a new way of living, with daily adaptations and with specific care to the location that involves guidance from the multidisciplinary health team. Let’s get to know some of the necessary guidelines for this patient.

Guidelines for the person with a permanent ostomy:

  • Advise the user that their hygiene can be carried out as usual. It is not necessary to remove the bag to shower, as soap and water do not harm the ostomy. It is only oriented as to the care with water jet in the locality that can cause injury in the place.
  • Instruct the user to change the ostomy bag when it is at its saturation point, which is when it becomes completely white. At this time, if there is no exchange, there is a possibility of content leakage. Remember that the staining of the plate can be an evaluation point.
  • Instruct the user to change the bag when necessary during the bath, as it is easier to move the adhesive without damaging the region. Skin care around the stoma is essential. Cleaning should be carried out with water and neutral soap without rubbing, rubbing or squeezing the place. Advise not to use sponge or other material to clean.
  • The region must be clean and protected, and the use of substances on site is not recommended. Exposing the site to the sun when possible is also beneficial. Alcohol, ointments and other substances on site are contraindicated. Zinc oxide ointment is indicated when there are diaper rashes caused by extravasation of feces.
  • Odors can be minimized with good nutrition and the use of activated carbon tablets. Food can cause diarrhea, constipation, gas or other complications and therefore, advise the patient to always eat in small amounts when the food is not consumed constantly, to avoid surprises.
  • Plate, spare bag, clothes and other hygiene instruments must accompany the patient in his daily life to avoid accidents. Professionals must guide at all stages, not implying that the patient will have such knowledge.

Final message

The mental health of the person with a permanent or permanent ostomy must be promoted by health professionals. The person who performs the ostomy may develop repulsion for the ostomy, difficulty going to work or school, difficulty or fear of physical activity and affective relationships. The professional should build a care plan that involves the constant psychological and emotional assessment of the patient, following the evolution and readaptation of the same. Issues involving the mental health of the ostomized person can be better understood in the text: The care of the mental health of ostomates.

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