Stoma care

Stoma: What does this term mean?

A stoma is a surgically created body orifice, for example an artificial intestine exit in the stomach wall, through which the intestine content is evacuated, when the natural intestine exit cannot be used because of an injury or a surgical intervention. A stoma can be created temporarily or definitely. The terms “urostoma” and “colostoma” are important for the patient. They mean artificial bladder exit and artificial intestine exit.

Living with a stoma 

An operation which makes the creation of a stoma necessary is generally a serious and burdensome intervention. The concerned patients need time to recover. A rehabilitation therapy is then crucial in order to learn to cope with the new situation and to recover physically. Even if some stoma forms are temporary, the affected persons need assistance and instruction concerning the care of the artificial body orifice in order to be able to lead an everyday life without difficulty as in the past. Moreover,
facing such a profound change is psychologically not easy.

Therapy goal

Beside the optimization of the stoma care and the treatment of stoma complications, we consider patient teaching regarding the correct and autonomous stoma care an important goal. Our patients shall furthermore learn in the therapy and in accompanying events to cope well with the psychological and psycho-social strains in the new living situation. Our holistic therapy shall enable the patients to manage practical problems of everyday life and to maintain the highest possible level of performance and of living quality.

How does the stoma therapy run in our house? 

From our long time experience in the accompaniment of patients with a stoma we have elaborated the following therapeutic standard for our institution.

Anamnesis

• Clarification of the basic disorder and of the primary care 
• Assessment of the knowledge about stoma care: we will talk with you about stoma systems used in the past and about potential problems which might have occurred in the past, such as instability or skin irritations 
• Acceptance or rejection of the stoma; other psychological problems concerning the stoma (partner problems, etc.)

First stoma consultation

• How is the stoma device fixed? How does the patient handle the stoma device? If possible, the patient ought to demonstrate the removal and the fixing of the device 
• Written report on the results, photo documentation, measuring of the stoma, explanation of errors in the past or of causes for problems 
• Evaluation whether the device of the past can be kept or whether changes are necessary 
• Clarification as to the involvement of the family or partners in the stoma care, if there is need 
• Definition of the rehabilitation goal

Therapy content

• Regular stoma care assistance 
• Weekly stoma consultation (personal talk) 
• If problems occur concerning the used stoma device, we offer alternative systems for testing 
• Training with regard to stoma device problems; if necessary, provision of auxiliary material; for example a cutting device to adapt correctly the perforation in the base plate 
• Clarification of the possibility of an irrigation treatment for the colostoma and of the patient’s readiness if such a treatment is indicated 
• Training of the patient and start of a supervised irrigation treatment

Additional measures accompanying the therapy

• “Group discussion of stoma patients” guided by a psychologist
• Possibility of participating in “tumour group talks”

Measures before release: prescription of an abdominal bandage (stoma bandage); fixing or suggestion of further necessary steps (for example surgical revision or prescription of an abdominal bandage by the doctor); preparation or organization of a stoma assistance or of a support in the stoma care by an outpatient stoma assistance service at home, if there is need; referral documents for future stoma assistance; “stoma device document”; information material

Preparation for the life after the rehabilitation

• Information on alternative help and assistance when problems occur at home concerning the stoma device 
• Information of the treating doctor if the patient might need stoma-related psycho-therapeutic assistance 
• Preparation of professional counselling if there is evidence that particular problems might occur in the exercise of the profession due to the stoma