Stoma Care TG Balachandar
INDEX
Page numbers followed by f refer to figure, fc refer to flowchart, and t refer to table.
A
Abdomen 55f
four quadrants of 61f
Abdominal contours 81
Abdominal distension 123
Abdominal radiation 117
Abdominal wall, anterior 6
Abdominoperineal resection 32, 85
Abscess 137
Accident injury 66
Adhesions 172
Alcohol 164
Allergic skin reactions 130
Amazing ostomates 158
Anorectal
anomalies 43
incontinence 42, 49
Antacids 109
containing magnesium 122
Antibiotics 109
Anti-reflux valve 172
Anus 17
defunctioning of 84
Atonic colon 31
Australian Council of Stoma Associations 156, 157
Azathioprine 135
B
Baby with colostomy bag 64f
Benzoyl peroxide, solution of 135
Bile salt pool 21
Bismuth subgallate 122
Bladder 52
cancer of 43, 52
exstrophy of 43, 53
Bleeding and peristomal varices 141
Blowhole transverse colostomy 91
Bowel
after excision, defunctioning of 84
defunctioning of 84
function, normal 116
ischemia 30, 42, 47, 48, 48f
obstruction 84f
Braided sutures 129
Brussel sprouts 163
Burns 85
C
Candida albicans 134
Caput medusa 138, 139f
Carbohydrates 21
undigested 121
Carcinoma 30
Cecostomy 32, 33, 37
Chlorophyllin copper (derifil) complex 122
Cloacal exstrophy 43
Colchicine 135
Colectomy 172
subtotal 32, 84
Colitis
acute 84
chronic 84
diversion 142
Colon 19, 48f
carcinoma of 47
inflammation of inner lining of 45f
injury 84
resection 93f
Colonic cancer 42
Colonic conduit 32, 37
Colonic inertia 85
Colonic obstruction 42, 47
Colorectal cancer 84
incidence of 1
Colorectal malignancy 47
Colorectal polyps 44f
Colostomy 22, 32, 35f, 57, 71, 84, 85, 109, 172
ascending 32, 32f, 33f, 37, 59, 172
Association 156
completed loop 28
descending 34, 34f, 37, 58, 60, 61f, 116
distal colostomy 24
double barrel 29, 29f
general 22
indications for 87t
irrigation 11, 116
principles of 117
left transverse 58
middle colostomy 23
nonfunctioning 133f
permanent 179
proximal colostomy 23
right transverse 58
sigmoid 32t, 34, 37, 57, 59f, 61f, 116, 180
temporary 117, 180
transverse 32, 32t, 33f, 34, 37, 59f, 60, 61f, 180
Congenital disease conditions 44
Constipation 85, 142
management of 125
prevention of 125
relief 106, 124
Contraceptives 109
Contracted bladder 43
Convexity 173
Cramping pain, severe 123
Crohn's colitis 84
Crohn's disease 30, 31, 41, 46, 46f, 83, 84, 169, 174
Cut-to-fit pouch 77
Cystic fibrosis 67
D
Dapsone 135
Davol product-made out of gum rubber 10
Decubitus ulcers 85
Diarrhea 19, 85, 142, 171
management of 122
stomal 142
Diet, influence of 19
Dietary and fluid modification 124
Digestion, complete process of 17
Digestive system
different parts of 17
works 16
Disease, excision of 84
Distal ileum, division of 90f
Diuretics 109
Diverticular disease 30, 42, 45, 83, 84
Diverticulitis 174
Diverting loop colostomy, completion of 29f
Drug
excretion 130
interactions 130
E
Ectopia vesicae 50
Eczema 130
Effluent under pouching system, leakage of 134
Electrolytes 122
Embolus 48
End colostomy 38, 84, 86, 87, 101f
End ileostomy 39, 84, 85, 88, 88f, 101
formation of 90f
End ostomy construction 174
Enterostomal nurse, role of 97
Enterostomal Therapists Nursing Education Program 7
Enterostomal therapy 100
nurses 145, 151, 175
Esophagostomy 37
Esophagus 17
F
Faceplate 175
Familial adenomatous polyposis 44, 175
Familial polyposis coli 41
Fascial defect 140
Fascial support, lack of 140
Fat malabsorption 21
Fecal diversion 85t, 127
Fecal incontinence 30, 84
Fecal pouch, application of one-piece 77
Feeding tube, placement of 41f
Fistula 85, 130, 134
peristomal 136
Fluid
and electrolyte balance 24
components 122
Fluid-electrolyte imbalance
management of 123
prevention of 123
signs of 122
symptoms of 122
Folliculitis 134, 175
Food
blockage, recognition and management of 123
intolerance 122
Fungal candida albicans 136
G
Gas
and odor, control of 121
forming foods 121
producing 106, 124
Gastric juice 19
Gastrointestinal
function 30
secretions 18f
tract 20f, 130
Gastrostomy 37
Gold coast ostomy association 156
Granuloma 133f
peristomal 133f
H
Handicapped ostomates, challenges faced by 150
Hartmann's procedure 27, 28f, 32, 38, 176
Healthy stoma 101f, 105f
Hereditary disorder 175
Hereditary non-polyposis colorectal cancer 41, 44
Hernia 136f
parastomal 136f
peristomal 116
Herniation, internal 139
Hirschsprung's disease 30, 43, 65, 66f
Human digestive system, parts and functions 16f
Hydrocolloid 137
Hydrocolloid skin barriers 8
Hygiene, poor 130
Hyperplasia, severe 137
Hypertension, portal 138
Hypovolemia 21
I
Ileal conduit 32, 39, 53, 177
stoma creation 54f
Ileal pouch anal anastomosis 22
Ileal resection 19
Ileal urinary conduit 161
Ileo anal
anastomosis 32
pouch procedure 84
Ileostomates 21
Ileostomy 31, 37, 38, 59f, 60, 61f, 84, 88, 109, 123, 131, 177
construction 22
continent 173
functioning 133f
lavage 139
permanent 161
pouches 71
predisposing diseases 31
well-established 139
Ileum 19
segment of 42f
Imperforate anus 65, 65f
Incontinence 85
Inflammatory bowel disease 31, 65, 83, 177
Inflammatory disease
complications 85
conditions 45
Inguinal colostomy 6
International Ostomy Association 155, 156
Intestinal consistency 20, 20f
Intestinal continuity 94
Intestinal segments 19
Intestine, small 24
Intrauterine device, use of 169
Irradiation damage 30, 49
Irrigating stoma 119f
Irrigation 178
Irritant dermatitis 103f
Ischemia 131
Ischemic bowel disease 137
J
Jejunal and ileal absorption, normal 18
Jejunostomy 30, 37
by Maydl's method 30f
Jejunum 19
resection 19
Joint diseases 150
K
Karaya 178
gum 8
Kock pouch 173
L
Lactase deficiency 21
Lactobacillus 122
Laparoscopic colostomy 92
Laparoscopic ileostomy 92
preparation for 93f
Laparoscopic instruments, orientation of 93f
Liver 17
Loop colostomy 27, 36, 42f, 84
closure of 36f
defunctioning of 87
Loop end colostomy 28f, 87
Loop ileostomy 37, 42f, 84, 89, 91f, 101f
ileo-anal pouch 32
Loop ostomy creation 178
Loop stoma 7, 36
M
Maydl jejunostomy 30
Meconium ileus 43, 67, 67f
Mental handicaps 150
Mental illness 150
Metabolic problems 133
Methotrexate 135
Motor neuron disease 150
Motor sensory illness 150
Mucocutaneous junction 138
Mucocutaneous separation 130, 132
Mucosal implants 140
Mucosal ischemia 131
Mucous fistula 35, 35f, 38, 39, 87f, 127
Myelomeningocele 50
N
Natural yoghurt 163
Nausea 123
Necrosis, stomal 131, 131f
Necrotizing enterocolitis 43
Neonatal necrotising enterocolitis 65
Neurogenic bladder 50, 52, 53
Nonadherent gauze 137
Non-steroidal anti-inflammatory agents 109
Nystatin topical powder 136
O
Obligatory ileal sodium 21
Obstruction
relief of 84
severe 50
Obstructive disease condition 47
Obstructive pulmonary disease, chronic 130
Odor
control 106, 124
prevent 170
producing 106, 124
Ostomate 108f, 152
bill of rights 127
diagnosis 149
for medical advice 149
groups 152
physically 121
troubleshooting foods for 124t
Ostomist
general dietary tips for 163
with fecal stoma 163
Ostomy 1, 2, 16, 161, 179
and social media 152
facebook 152
twitter 152
youtube 153
appliances at display 160
Association of India 155
Association of Los Angeles 7
Associations in India and abroad 155
bag
one-piece 72f
two-piece 72f
care 100
agencies in 154
development of 13, 14
terms of 153
closure and time 96
double barrel 127
management 127
system 55
permanent 179
pouches 10f
and accessories 72f
pouching systems 179
service 154, 155
development of 155
surgery 127, 145
temporary 179
to student nurses, planning and teaching of 145
travel kit 112f
visitor 147, 148
medical advice 149
permission 148
privacy 149
qualities of 147f
role of 147
P
Pancreas 17, 67
Pancreatic juices 19
Panproctocolectomy 32, 84
Paraplegia 85
Parastomal 176
abscess 134, 135
hernia 129, 135, 136
Pectin skin barrier 56
Pediatric conditions 43
Pediatric stoma care 64
Peg tube placement 41f
Pelvic radiation 117
Pelvic sepsis, severe 169
Pendulous abdomen 58f
Peppermint tea 163
Perianal disease 84
Perineal resection, abdominal 38
Peripheral neuropathy 150
Peristomal abscess 130, 134
Peristomal candidiasis 179
Peristomal contact dermatitis
allergic 179
irritant 179
Peristomal problems 137
Peristomal skin 136
irritation 130, 132
prevention 132
protection 36
Peristomal skin/plane 179
Peristomal varices 141, 141f
Perspiration 130
Plasma sodium concentration 21
Plastic rod 28
Polyposis 44
Poor general health 130
Pouch 54
after emptying, removing 78f
change, timing of 73
off in bath 166
pre-sized 77
selection criteria and options 81t
sizing of 74
Pouching options 81
Pouching selection 81
Pouching system 56fc, 57fc
part of 175
procedures 71
two-piece 180
types of 71
Predisposing diseases colostomy 30
Proctocolectomy, total 85
Prolapse, stomal 140, 141f
Prowess stoma care 154
Psoriasis 104f, 130
Pyoderma 135
gangrenosum 135
R
Rectal cancer 42, 84
Rectal fistula 85
Rectal injury 84
Rectus muscle
sheath 60
splitting of 90f
Rheumatoid arthritis 150
S
Saliva, composed of 19
Scars 56
Scelerosing cholangitis, primary 141
Sclerosis, multiple 150
Semi digested food travels 17
Sepsis, resolution of 84
Short chain fatty acids, deficiency of 142
Sigmoid colon, resection of 7
Skin
barrier 79f, 180
care, routine 143
complications
causes 103fc
management 103fc
types 103fc
condition 102
creases 56
permeability, changes in 130
preparation-soaps 130
problems 130
surrounding stoma, cleaning 78f
Small bowel
disease 84
stoma 121
water absorption, determinant of 21
Sodium
absorption 19
losses, stomal 21
Sphincter repair 84
Spina bifida 43, 50, 52, 53, 66, 67f
Spinal cord
injury 52
trauma 50
Split ileostomy 84
Stenosis 130, 138f
sight of 137
treating mild 137
Steroids 109
Stoma 57, 127, 135, 137, 140, 142, 168, 180
appliance 8, 105f
key developments in 8
used 166
appropriate 132
bag 112f
children's 69f
infant with 68f
care 12, 64, 68, 149, 153, 160
evolution of 3
history of 3
nurse 162, 170
websites offering 153
characteristics 81
classification of 41
closure 35
color of 100
complications 129, 129fc
type of 129
concealment of 124
construct good 121
construction, methods of 83
creation 145
principles of 55
defunctioning 129
diverting 41, 42f
drug possible effect on 171
edema of 133
end 38
eversion of 89f
flush 175
forming surgery 1, 162, 165
functioning of 145
good healthy 121
input 41, 41f
large bowel 121, 123
locations, desirable 60, 61f
maintenance of 116
marking, site of 90f
nonfunctioning 127
nurses, on call 152
obstructing 106, 124, 140f
output 41, 42f
patient, educating 126
physiology of 18, 19
pouch made of plastic bag 11
presence of 126
problems in 121
products, application of 77
prolapse 116
retracted 131, 132f
retraction, incidence of 131
revision 142
site
marking of 62f
of abdominal 26
selection 59
sitting, poor 130
spout and size 102
stricture 137
support group 152
surgery 2, 4, 67, 84t
key developments in 4
principles of 83
surgical principles of 83
swelling 123
temporary 83
types of 26, 37t, 60, 81, 84t, 145
Stomal complications 130t
Stomal lumen, constriction of 137
Stomal skin
causes of 134t
complications, causes of 134t
management causes of 134t
Stool
control, loose 124
increased/loose 124
malodorous floating 21
Stress incontinence 52f
Stroke 150
Surgeon and stoma nurse 147
Surgery
incidence of 50
principles of 92
Sweat glands 67
Swelling, stomal 123
T
Toilet-flushable pouches 10f
Transjugular intrahepatic portosystemic shunt 138
Transureteroureterostomy 53
Trauma 30, 49, 8385, 142
abdominal 3
Travelers’ diarrhea 167
Trephine 91
colostomy procedure 92f
U
Ulcer 134
pressure 104f
unroof 134, 137
Ulcerative colitis 31, 41, 45, 66f, 84, 161, 180
stages of 46f
Umbilicus 56
Underwent permanent ileostomy 161
United Ostomy Association 7
America 155
Ureteral anastomosis 95f
Ureteral conduit anastomosis completed 95f
Uretero-colic anastomosis, failed 43
Ureterostomy 37
Uric acid stones 22
Urinary
bladder to cancer 161
conduit 50
diversion 50, 51f, 52, 53
incontinence 43, 53
pouch, application of one-piece 81
pouching systems 180
stoma 1, 53
construction of 51
pouch system options for 79
stone formation 22
system 43
normal 50f
tract 50
abnormalities of 52
Urostomy 39, 54, 60, 61f, 109, 177
continent 173
pouch 53f
V
Vesicostomy 53
Visual
deficits 150
illness 150
Vitamins 109
Volvulus 32, 47, 85
Vomiting 123
W
Warfarin 171
World media plays 152
World Ostomy Day 159, 160
Wound ostomy continence nurse, role of 151
Wound, Ostomy and Continence Nurses Society 156
Y
Yeast infection 104f
×
Chapter Notes

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IntroductionCHAPTER 1

According to the available literature, it is estimated that 450,000 people in US currently have a Stoma and 120,000 new surgeries are performed each year.
The United Ostomy Association estimates that slightly more than 500,000 Americans have some type of Stoma. In UK, there are around 130,000 Ostomates.
In India each year, more than a 100, 000 people undergo surgery in which Faecal or Urinary Stoma is made. Majority of the patients who are living with Stoma is due to the treatment given for colorectal cancer. However Stoma forming surgery may be undertaken for other benign conditions like Ulcerative colitis, Crohn's disease, Diverticulitis or complications with Bowels function and genetically predisposed bowel diseases.
In India, every year the incidence of colorectal cancer is increasing in number, but the number of ostomy cases are not much, especially it has been witnessed that in the past 2 decades there is a steady increase in the temporary stomas and a fall in the permanent Stomas which is due to the revolution in the surgical management of Colorectal cancer by Minimal invasive surgery and advancement in the chemoradiation techniques, where in sphincter saving surgery have increased simultaneously with a covering Ileostomy as a temporary measure.
In India there are 300,000 registered Ostomates besides roughly the same number of unregistered Ostomates. On an average about 10,000 Ostomy surgeries are carried out, of which 1/3 may be temporary Ostomies.
In Tamil Nadu, approximately 3000 Ostomy surgeries are happening every year with 70% as temporary and 30% as permanent Stoma. 5% of the total group is Paediatrics. Average age group falls between 40 and 60 of which 40% are females and 60% are males.
In earlier years, the stoma was not envisioned or created by the surgeons but by the forces of nature. For example, the result of a strangulated hernia in those individuals, fortunate enough to survive or those who survive with abdominal wounds with visceral injury live with a permanent enterocutaneous fistula as a Stoma.
But in the modern era, Stoma forming surgery has revolutionised in to a purposeful creation of an opening on the surface of the abdomen which can be well maintained by the patient. These people live normal lives and some of them even enter in to a very challenging professional life.2
Advancements in Stoma surgery and Ostomy management systems have given a new ray of hope that, Ostomates can also lead an active and normal life.
BIBLIOGRAPHY
  1. Diseases of the Colon and Rectum; Centennial Articles in colon and rectal surgeon; Intestinal stomas; 200 years of digging Peter A Cataldo MD. From the Medical Center Hospital, Fletcher Allen Health Care,  Burlington, Vermont. https://link.springer.com/article/10.1007/BF02237118
  1. Intestinal Stomas Principles, Techniques and Management second edition, revised and expanded; History of stomas–Peter Cataldo.