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Chapter-09 Principles of Stoma Creation and Selecting the Stoma Site

BOOK TITLE: Stoma Care

Author
1. Balachandar TG
ISBN
9789352704873
DOI
10.5005/jp/books/18070_10
Edition
1/e
Publishing Year
2018
Pages
9
Author Affiliations
1. Apollo Hospitals, Greams Road, Chennai, Tamil Nadu, India
Chapter keywords
Stoma, stoma site, pouching system, sigmoid colostomy, descending colostomy, transverse colostomy, rectus muscle, adequate surface area, smooth skin surface

Abstract

This chapter familiarizes the readers with the principles of stoma creation and selecting the stoma site. The objective of stoma construction is to provide an anatomically stable opening allowing placement of an ostomy management system that will maintain a seal of stool and gas for 4–7 days. The stoma must be constructed so that it is visible to the patient. It should be located away from the umbilicus, skin creases, scars, and bony prominences. Areas of skin damaged by irradiation or skin grafts also should be avoided. The first step in the construction of enterocutaneous stoma is the selection of appropriate site. Stomas should be located within the rectus muscle; if the stoma is brought outside the rectus muscle, the incidence of parastomal hernia is very high. To select the correct site for the stoma, the assessments should be made preoperatively which are type of stoma anticipated, the rectus muscle sheath, adequate surface area, easily seen, smooth skin surface, and marking the site.

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