Colostomy

 

 Colostomy

Definition

It is an operation in which an artificial anus is prepared on the anterior abdominal wall for drainage of faeces.

 

Indications.

1.Growth of the pelvic colon  or rectum.

2.Injury to the rectum:To prevent contamination of the wound by faeces.

3.Congenital absence of rectum.

4.Imperforate anus:High type.

 

Types

 

Types of colostomy

Type	Features
Loop colostomy	A loop of the colon is brought out on the anterior abdominal wall.It is kept in place by passing a glass rod through its mesocolon.
Defunctioning colostomy	The loop of the colon brought out on the anterior abdominal  wall is divided, so that there is no connection between its two openings,and stools from the proximal segment can never pass into the distal  segment.
Terminal colostomy	The lower colon is completely removed and the cut end of the proximal segment is brought out on the anterior abdominal wall as colostomy.

 

 

Nursing care

1.The flatus in the colon escapes, when the colon is opened, and the patient experience a great relief.

2.The function  of the colon mat not return to normal immediately,and may be irregular for quite some time. Hence light diet is given until it becomes  normal.

3.Liquid paraffin is given 15 ml 8 hourly orally.

4.If the stool remains hard,despite these measures,dulcolax suppository is passed through the colostomy opening.

5.That  increase the movement of the colon and stools become liquid and come out easily.

6.Sometimes bowel wash has to be given through the colostomy .However too frequent bowel washes are best avoided as they can cause colitis.

7.In case of a loop colostomy,there are two openings. The nurse should be able to identify the active stoma, through which the stool comes out.she has to give enema or bowel wash through this opening.

8.The patient is ambulated on the evening or the next morning after the surgery.

9.Sutures are removed on the tenth day.

10.Easily digestible food is given.

11.The patient is taught how to take care of the colostomy, how to maintain cleanliness and hygiene,and how to remove and attach colostomy bags.

12.In case of diarrhoea,he is given kaolin and if it fails to control his symptoms,he is referred to the doctor.

 

Complications

1.Wound infection.

2.Prolapse of bowel through colostomy.

3.Retraction of Colostomy.

4.Intestinal obstruction.

5.Stricture of colostomy opening.