Ostomy Tips

8 Stoma Infection Signs You Shouldn't Ignore

A stoma is a surgical opening in the abdominal wall created to eliminate body waste (feces or urine) when there is a problem with excretion through the normal route. Body waste is collected in an ostomy pouch which is attached to the stoma. Stomas are commonly created as diverting measures in managing gastrointestinal malignancies, bowel or bladder obstructions, or inflammatory bowel diseases.

The stoma and the surrounding area  (peristomal skin) remain delicate, especially after surgery, and require a special skin care regimen to keep it clean and healthy. After ostomy surgery, skin health is vital in regaining and maintaining a healthy and comfortable lifestyle and avoiding peristomal skin complications (PSCs) and stoma infections.

Infection of the stoma is one of the main worries of an ostomate. Skin infection around the stoma can happen for various reasons, so it is important to check your stoma and peristomal skin with each ostomy pouch change to identify any new issues should they arise.

How should the Peristomal Skin look?

The peristomal skin should look just like the skin on the rest of your abdomen or body. It should be smooth, clean, and dry. There should be no discoloration, redness, itchiness, or lesions of any kind. If you notice any difference in the peristomal skin, contact your doctor immediately. 

8 Stoma Infection Signs 

Changes in the stoma and the surrounding skin often indicate an issue that may require immediate treatment. Contact your surgeon or ostomy nurse if you see the following signs:

1. Pain, discomfort, or itchiness around the stoma
2. Swelling and redness around the stoma 
3. Pus-like discharge from the stoma 
4. Stoma turns from normal pink or red to dark red, purple, or black.
5. Frequent leakage from the pouching system 
6. Excessive bleeding from the stoma; slight bleeding is normal after you wash the stoma, which resolves quickly
7. Blisters or warts under the skin barrier
8. Any type of wound, scratch, or rash on the peristomal skin

Causes of Peristomal Skin Complications

• Ostomy leakage: Using the incorrect size or type of ostomy skin barrier can result in leakage of body waste under the skin barrier. This will cause the skin to become irritated and begin to break down with repeated contact with urine or stool.
• Contact dermatitis or allergic dermatitis: Allergic reactions with an element in the skin barrier or the adhesive on the barrier can cause rashes and infection.
• Mechanical trauma: Common causes of peristomal skin trauma are friction or pressure. Ill-fitting appliances, abrasive cleaning, removing skin barrier improperly, and frequent appliance changes may irritate and strip the skin, causing peristomal skin problems.
• Folliculitis: Inflammation or infection of the hair follicles near the stoma can cause tiny, red, painful bumps. 
• Fungal infection: Fungal infections like peristomal candidiasis can begin as a red rash accompanied by itching and burning. Perspiration, leakage, and prolonged wear time of ostomy appliances are some of the potential causes of the infection.
• Poor ostomy hygiene: Proper care and cleaning are crucial for stoma health. Improper cleaning practices can cause rash, redness, or infection.

Treatment for Stoma Infection 

If you see evidence of peristomal skin complications or stoma infection or have concerns regarding your ostomy, speak with your doctor or ostomy nurse. A qualified healthcare professional can diagnose the issue and prescribe medication if necessary.

Tips to avoid Stoma Problems 

You can avoid stoma complications by following these simple suggestions:

• Keep your stoma and peristomal skin clean
• Use the right ostomy supplies for your needs. Choose a well-fitted skin barrier to prevent ostomy leakage.
• Change ostomy appliances at the right frequency 
• Use proper skincare products
• For sensitive and moist skin, apply stoma powder to help ease dampness and skin irritations.
• Ensure the peristomal skin is completely dry before replacing the pouch and skin barrier.
• Always remove the skin barrier gently and never put excessive pressure or rip or tear it off abruptly.
• To protect against skin irritation and skin allergies due to adhesives, (adhesive allergy) use barrier wipes that provide a thin barrier of film on the skin.
• You can also use adhesive removers to gently remove the adhesive residue from the skin to help prevent skin irritation.

Ostomy Supplies to prevent Signs of Stoma Infection

7. Coloplast Brava Non-Sterile Ostomy Powder

Used for skincare around the stoma, this stoma powder effectively absorbs moisture and reduces skin irritation. Regular use can reduce the occurrence of peristomal skin problems. Before using the ostomy powder, clean and dry the stoma and the surrounding skin.

How to use Brava Ostomy Protective Powder?

• Wash and dry the peristomal area.
• Unscrew the cap and aim at the stoma.
• Gently squeeze the bottle over and spread the powder on the stoma skin.
• Use toilet paper, a wipe, a finger, or gauze to spread the powder evenly.
• Dust off the excess powder before applying the ostomy barrier.
• Close the cap tightly after use and store it in a cool, dry place.

 

An infection of the stoma is a serious condition. Make a note of how your peristomal skin looks when it is healthy. Once you know what healthy skin looks like, you can watch for signs of skin infection. Inspect the skin around the stoma with each pouch change. If you see any unusual signs, do not ignore them and notify your doctor or ostomy nurse immediately before the condition worsens.

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