Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword by Professor Lord Ara Darzi KBE
- Preface
- Section 1 Perioperative care
- Consent and medico-legal considerations
- Elective surgery
- Special situations in surgery: the diabetic patient
- Special situations in surgery: the jaundiced patient
- Special situations in surgery: patients with thyroid disease
- Special situations in surgery: steroids and surgery
- Special situations in surgery: surgical considerations in the pregnant woman
- Haematological considerations: thrombosis in surgery
- Haematological considerations: bleeding
- Haematological considerations: haemorrhage (massive-bleeding protocol)
- Haematological considerations: blood products and transfusion
- Shock
- Fluid management
- Electrolyte management
- Pain control
- Nutrition
- Antibiotic prescribing in surgery
- Critical care: the critically-ill patient, decision making and judgement
- Critical care: cardiovascular physiology and support
- Critical care: respiratory pathophysiology and support
- Critical care: renal support
- Critical care: other considerations
- Postoperative complications
- Surgical drains
- Abdominal stoma care
- Section 2 Surgical emergencies
- Section 3 Surgical disease
- Section 4 Surgical oncology
- Section 5 Practical procedures, investigations and operations
- Section 6 Radiology
- Section 7 Clinical examination
- Appendices
- Index
Abdominal stoma care
Published online by Cambridge University Press: 06 July 2010
- Frontmatter
- Contents
- List of contributors
- Foreword by Professor Lord Ara Darzi KBE
- Preface
- Section 1 Perioperative care
- Consent and medico-legal considerations
- Elective surgery
- Special situations in surgery: the diabetic patient
- Special situations in surgery: the jaundiced patient
- Special situations in surgery: patients with thyroid disease
- Special situations in surgery: steroids and surgery
- Special situations in surgery: surgical considerations in the pregnant woman
- Haematological considerations: thrombosis in surgery
- Haematological considerations: bleeding
- Haematological considerations: haemorrhage (massive-bleeding protocol)
- Haematological considerations: blood products and transfusion
- Shock
- Fluid management
- Electrolyte management
- Pain control
- Nutrition
- Antibiotic prescribing in surgery
- Critical care: the critically-ill patient, decision making and judgement
- Critical care: cardiovascular physiology and support
- Critical care: respiratory pathophysiology and support
- Critical care: renal support
- Critical care: other considerations
- Postoperative complications
- Surgical drains
- Abdominal stoma care
- Section 2 Surgical emergencies
- Section 3 Surgical disease
- Section 4 Surgical oncology
- Section 5 Practical procedures, investigations and operations
- Section 6 Radiology
- Section 7 Clinical examination
- Appendices
- Index
Summary
Stoma classifications
There are three basic types of eliminating stomas:
Ileostomy: opening into the ileum (small intestine)
Colostomy: opening into the colon (large bowel)
Urostomy: opening into the urinary tract.
A fourth, but less common, eliminating stoma is that of a jejunostomy – an opening into the jejunum.
Different stoma types
Ileostomy: constructed mainly from terminal ileum. Usually sited in the right iliac fossa (RIF). Output is variable (loose/watery) but mostly a thick porridge consistency. Daily output is approximately 600–800 ml. An ileostomy is spouted, protruding 6–25 mm from the abdominal wall surface (Figure 18). A drainable bag is required. The bag is emptied 3–7 times in 24 hours. A low-fibre diet is recommended.
Colostomy: constructed from ascending, transverse, descending or sigmoid colon. Usually situated in the left iliac fossa. Output is thicker/more formed/contains less fluid. A colostomy is flush with the abdominal wall surface (Figure 18). A closed bag is required. The bag is changed 1–3 times in 24 hours. A high fibre, high fluid intake is usually recommended.
Urostomy/ileal conduit: constructed from 10–15 cm of ileum (implantation of the ureters into ileum). Usually situated in the RIF. With a fluid intake of 2–2.5 litres a day, 1.5–2 litre output is expected. A Urostomy is spouted (6–25 mm). The mucosal lining produces mucus on a daily basis. A bag with a tap outlet is required. The bag is emptied 3–7 times in 24 hours. (Night drainage system is also used.) A high fluid intake is advised (to reduce the risk of infection).
- Type
- Chapter
- Information
- Hospital SurgeryFoundations in Surgical Practice, pp. 141 - 146Publisher: Cambridge University PressPrint publication year: 2009
- 3
- Cited by