Stoma Complication And Nursing Management

Abstract

Introduction- A stoma is a surgical Exteriorization of the bowel for diversion of the fecal material, it may be temporary or permanent, depending upon the patient's disease condition. it is a common procedure for the short-term or long-term management of benign and cancer surgery. End colostomy and loop colostomy are two different types of colostomy.  In End colostomy, parts of the large bowel (colon) or rectum are removed, and the remaining large bowel is brought to the surface of the abdomen to form a stoma,  it may be temporary or permanent. In Loop colostomy, the bowel is lifted above skin level and held in place with a stoma rod. This article focuses on the early and late complications. Early complications occur within 30 days of surgery; late complications occur after 30 days. Early postoperative stoma complication is skin irritation, leakage, bleeding, necrosis, mucocutaneous separation, fluid and electrolyte imbalances, and retraction. Late stoma complication stoma prolapse, para-stomal hernia, and stenosis.  Role and responsibility of nurses- The nurses working in oncology center plays a key role in assessment and management of complication either by a medical condition or surgical procedure such as stoma, ICD, and breast surgeries. It has been seen that many types of stoma complications can affect a patient’s psychological health after surgery, and site selection has been associated with fewer ostomy-related complications (eg, leakage, dermatitis). Nurses should Prepare the Patient for Stoma Surgery and explain the pros and cons of stoma surgery. Clear all questions asked by patients before surgery. Prepare the patient for adaption to new patterns of life after stoma. Conclusion Stoma formation is performed for diversion of fecal or urinary materials, it may be planned or emergent. It may cause complications postoperatively. The necessity for a surgical revision could be avoided by paying close attention to the many technical elements that play a key role in delivering and maintaining a healthy stoma. The patient's surgical outcome and long-term quality of life are affected by surgical skill, unexpected intraoperative complications, anatomical difficulties, and comorbidities, and post-operative stoma care at the stoma clinic as well as home. Nurses working in stoma care clinic, as well as oncology center, plays a unique role for maintaining an ideal stoma site and secure pouching seal. Nurses should aware of complications caused postoperatively, and should be competent to manage them.