Patient Support Information: Ostomy Basics

The Stoma

Following surgery, and for as long as the patient has a colostomy, ileostomy or urostomy, effluent (stool or urine) will exit the body through the stoma and a system for collection and protection of the surrounding skin is required. These are ostomy appliance systems. No two stomas are exactly alike. Each stoma, depending upon it's size and shape, presents its own unique challenges for the caregiver and patient. This section will give you an overview of how to identify which type of stoma your patient has and how to best care for it.

All liquid or semi-liquid effluent can damage skin when soilage remains in contact with skin over time. Urine and ileostomy drainage in particular since it has a high content of digestive enzymes are particulary caustic and can irritate and denude peristomal skin more quickly than solid waste. The use of a skin barrier that fits the stoma snugly and a good collection pouch is essential to maintaining healthy peristomal skin.

Stomas have no nerve endings and do not transmit pain. They are, however, rich with blood vessles and may bleed slightly if rubbed or irritated.

Different Stoma Types:

Protruding Stoma

Ideally, during the ostomy procedure, the surgeon will create a stoma that protrudes beyond the skin of the abdomen (protruding stoma). This allows the skin barrier to be applied close to and around the outer edges of the stoma. For a patient with a protruding stoma, the goal is to help achieve a leak-proof seal at the stoma edge. This protects peristomal skin from effluent seeping underneath the skin barrier at the stoma edge and onto the peristomal skin.

While the protruding stoma is preferred and easiest to care for, some stomas are more difficult to manage. Two of these are a flush stoma and a retracted stoma.

Management Goal:
Leakproof adherence that protects peristomal skin from the damaging effects of urine and stool utilizing an appropriate pouching system that adequately contains and collects the volume and type of stomal output.

Flush Stoma

Unlike a protruding stoma, a flush stoma does not protrude beyond the skin of the abdomen. A flush stoma, as the name suggests, is flush with the skin covering the abdomen. Flush stomas may be the result of a surgeon's chosen technique, or may occur over time, even though a protruding stoma was originally created.

A flush stoma may require the use of a convex skin barrier. The convex shape of the barrier applies gentle pressure around the stoma edge, increasing the degree of stoma protrusion.

Management Goal:
Elimination of uneven skin surfaces to create a level surface onto which a convex pouching system may adhere and press into the surface area around the stoma to increase the degree of stomal protrusion.

Retracted Stoma

A retracted stoma is recessed to slightly below the skin surface. Recessed stomas can occur over time due to internal surgical scarring, weight fluctuations, and other unforeseen events.

Like the flush stoma, a retracted stoma calls for the use of a convex skin barrier. This will assist in achieving greater stomal protrusiton and make adherence and conformity easier to achieve.

Management Goal:
Elimination of uneven skin surfaces to create a level surface onto which a convex pouching system may adhere and press into the surface area around the stoma to increase the degree of stomal protrusion.

Patient Resources: Ostomy Surgery

Leaving the hospital is an important milestone for your ostomy patients, but it also can cause anxiety for anyone with a new stoma. It’s normal for your patients to feel nervous about living with an ostomy, but it’s also important to remember they are never alone.

Your patients may have many questions in the days and weeks following their surgery. They may feeling depressed, angry, or frustration until they get comfortable with their pouching system. All of these feelings are perfectly normal and where you come in to help ease these unease feelings.

Still Have Questions?
Our expert team of me+™ ostomy nurses and product specialists is only a phone call away, click here to Contact Us or Call: 1-800-422-8811 (Monday-Friday, 8:30am-7:00pm ET), Email: cic@convatec.com