Type of excretion | Anus praeter – the artificial anus

Type of excretion

In the case of ileostoma and coecostoma, the stool is first 1-2 l, later 500 – 750 ml of liquid to thinly pulped stool. This stool is also partly aggressive, as it contains a lot of bile acids and digestive enzymes. In tranversostoma and colostoma, one sees a thick-pulpy to shaped stool and a stool frequency of 1 – 3 times/day (colostoma) and 3 – 4 times/day (transversostoma).

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Here, a distinction is made between one-piece and two-piece systems. A system consists of a skin protection plate and a bag. A one-piece system is mainly used in the tranversostoma and colostoma, as the stool is mushy to solid, the changing of the bag is limited to 1 – 3 times per day and therefore the skin is not stressed by the changing.

This system consists of a skin protection plate and a bag, which cannot be separated from each other, thus forming a whole. The two-part system is a system where the skin protection plate and the bag can be changed separately. This makes it possible to limit the changing of the skin protection plate to every 3 to 4 days and then change the bag if necessary.

For fixing the bag, there is a snap ring on the skin protection plate where a bag can be fixed and thus no chair leakage occurs. The skin protection plate can be glued or fixed with a belt. A distinction is made between an open (wiping bag) and closed bag.

With the wiping bag, the bag can be emptied without changing the bag. The bag is closed by a clamp. This system is mainly used in ileostoma, as the consistency of the stool is very fluid and requires frequent bag changes, which in turn would be very stressful for the skin.

The closed pouch system can also be used in transversostoma and colostoma, as emptying is not so frequent here. With the skin protection plate, the opening can already be adapted to the size of the stoma and can be used immediately. However, it is also possible that the size of the ostomy has to be cut individually first. For this purpose, a template is required which is standardised to the individual stoma size. With this template you save yourself the trouble of measuring the stoma size again and again.

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For the stoma care you will need water, pH-neutral soap, a bag to throw away, gloves if necessary, a razor if necessary and toilet paper, compresses or cellulose. Given if the stencil, scissors and a pen. If the skin protection plate and the bag are changed, proceed as follows: First, carefully remove the skin protection plate and bag and dispose of it in the bag provided.

The bag can be knotted after the treatment and disposed of normally in a waste bin. Then clean the skin with wet compress/pulp and soap from the outside to the inside. Care should also be taken to wipe away any soap or grease residues (cream) so that the subsequent application of the new skin protection plate is not made more difficult.

The skin is dried with a dry compress/pulp. With a (disposable) razor the existing hair in the stoma area can be removed. This is to prevent hair folliculitis when changing the skin protection plate, where hairs can be torn off again and again.

In addition, the skin protection plate to be stuck would not stick if the hair growth is strong. In order to avoid injuries to the stoma, shaving is carried out away from the stoma. Attach the skin protection plate and the bag. If necessary, use the template to determine the opening of the skin protection plate beforehand.