Looking after your stoma post surgery

Keeping the skin around your stoma healthy

Most people living with an ostomy experience irritated skin now and then. However, irritated skin is not normal. In order for your ostomy pouch to be comfortable and worry-free, it is important to prevent skin irritation and maintain healthy skin around your stoma.

The cycle of irritation

Leakage leads to contact between output from the stoma and the skin, which causes irritation. Once your skin becomes irritated, the adhesive on the pouch won't attach properly leading to more leakage and continued skin irritation. It is important to prevent leakage and keep the skin around your stoma healthy. A proper fitting pouching system and the appropriate accessories can help prevent leakage.

Six steps to healthy skin around your stoma:

• Make sure your skin is clean and completely dry before applying the adhesive part of the pouch
• Adjust the hole in the adhesive so that it fits exactly the diameter of your stoma. After surgery, it’s normal for your body shape to change. It’s important that you keep checking to see if your template is the right size and shape for your stoma. Check this by positioning your cutting template over your stoma to see if the hole fits perfectly.
• Regularly check the size of the stoma, especially if you have a hernia
• Ensure full contact between the adhesive and your skin by exerting light pressure with your hand
• Change your appliance as soon as you feel any itching or discomfort
• Make sure to use the stoma appliance and accessories most appropriate for your body profile

Choose the right type of stoma appliance that fits your body

Find the right accessories

How does it look after surgery?

When you wake up after the operation you’ll be wearing your first pouch. This will probably be a clear one so that your nurses can check on your new stoma easily. You may also have drips and drains attached to your body. This is perfectly normal and they will be removed with very little discomfort when appropriate.

Your stoma

Your stoma will be moist and pinkish-red in color and should protrude from your abdomen (though it's also common for a stoma to remain flush with the skin surface). It may be quite swollen to begin with but will reduce in size over time – usually 6 to 8 weeks after surgery. Your stoma is a mucous membrane, just like the mucous membrane inside your mouth. There is no sensation in the stoma, so it is not at all painful to touch. The stoma can bleed a little when being cleaned, especially in the beginning, but this is normal and should stop shortly afterwards.

Your stoma will begin to work shortly after your operation, usually within a few days. At first the output will be a watery liquid and may be strong-smelling as your bowel hasn’t been working for a while. Don’t worry, though, the consistency will thicken slightly and the smell will diminish as you resume a more balanced diet. Your doctor will advise you when you will be able to eat and drink as usual.

Initially, it’s also likely that a certain amount of noisy gas will come from the stoma – again this is perfectly normal. It is not uncommon to feel the use the restroom as you did before. This is normal and should reduce with time. If your anus is still present, there may be some mucus discharge from it.

Urostomy

If you have a urostomy, the stoma will begin to work immediately after your operation. The tubes -- called "stents" -- placed in the urostomy will be left in place for seven to ten days. At first, your urine may be slightly red, but it will soon return to its usual color.

Becoming confident with your stoma

After your operation, your stoma care nurse will focus on helping you become confident in taking care of your stoma. It will help to have a close relative or spouse with you for this training.

Your nurse will help you with:

• Learning how to care for your stoma, including what to watch out for
• Re-ordering stoma pouches and accessories
• Your rights regarding reimbursement and other economic support relating to your stoma
• Other practical aspects of living with a stoma, e.g. foods and drink, your social life, travelling and your intimate relationships
• Who to contact when you have questions
• Ostomy association support groups in your area

Ask questions

There will be a lot of new information to take in at once; it may even feel a bit overwhelming. Take your time and ask all the questions you need, as many times as you need to. The more you ask and try things out, the better prepared you will be once you are back at home.

Before you leave the hospital, your enterostomal therapy nurse will likely make arrangements for follow-up care to make sure you feel confident caring for your ostomy.

Overcoming challenges

Once you are home, you may experience some challenges caring for your stoma. But remember that your ET nurse, as well as our Consumer Support Specialists, will be more than happy to help you with any issues.