Colostomy- a life-saving surgical procedure that saves an individual from conditions such as colorectal cancer, inflammatory bowel disease, and diverticulitis. A stoma or an opening is created in the abdominal wall that diverts the content of the large intestine of the body and a colostomy pouch is attached to the stoma that holds the waste products.
Be it temporary or permanent colostomy, it requires proper hygiene and care which involves managing and changing the colostomy bag from time to time. Changing the colostomy bag is not at all a difficult task. Initially ostomy nurse changes the bag for you but later on nurse will guide you on how to change the colostomy bag.
This comprehensive guide will provide a detailed, step-by-step guide on how to change a colostomy bag.
STEP-BY-STEP GUIDE TO HOW TO CHANGE THE COLOSTOMY BAG
Before starting the procedure, wash your hands thoroughly with soap and water. Make sure to collect all the necessary supplies which include:
- New colostomy bag
- Adhesive remover wipes
- Mild soap
- Warm water
- Stomahesive powder
- Measuring card
- Disposable gloves
Step 1: Prepare the Work Area
Select a well-cleaned and bright area to change the colostomy bag. A bathroom works well. Lay out a clean and old bath towel on the floor and ensure all supplies are within reach. Wear gloves on both hands.
Step 2: Remove the Old Bag
First of all, empty the pouch before removing it. Place one hand on the skin and the other hand on the wafer; gently lift the wafer off of the skin. Adhesive remover wipes would make this job easier. Now wash the adhesive on the skin with soap and water, and pat dry the skin. Skin drying is a crucial step if you do not do this, the next wafer may not stick to your skin well. Place the old and used colostomy bag into a plastic bag and throw it into the dust bin.
Step 3: Wash and Clean the Stoma and Peristomal Skin
Carefully wash and clean the skin around the stoma with warm water and a mild soap. You can also use a specialized stoma cleanser for this purpose. With soft hands, clean the stoma and skin around the stoma. Be gentle, do not scrub. Once you are done with washing, pat dry the area with a clean towel.
Step 4: Assess the Stoma
Carefully assess the stoma and skin around the stoma for any signs of irritation, redness, or abnormalities. There are two possibilities:
- If there is no irritation: Then simply wipe the skin around the stoma, where the wafer will touch the skin
- If the skin is raw, wet, or open: then it is advisable to sprinkle Stomahesive powder on the skin which will absorb all the moisture and help the skin heal. Let it dry for one to two minutes.
Step 5: Measure the Stoma (if needed)
If your colostomy bag requires a customized fit, use the measuring guide to measure the stoma. The hole in the new colostomy bag should match the stoma’s size for a proper fit. The measuring card comes with circles of different sizes, find the circle size on the card that fits closest to the stoma. Do not touch the measuring card to your stoma as this will promote germs contact.
For your information, stoma size and shape changes during the initial four weeks after surgery because of a decrease in swelling.
Step 6: Prepare the New Bag
Now, from the measuring card, trace the chosen circle size onto the back of the wafer paper. Cut the wafer to the circle size. Remove the adhesive backing from the back and get ready to apply it on the skin. If you have a two-piece pouching system, attach the pouch to the plastic ring on the wafer.
Step 7: Apply the New Bag
Carefully place the new colostomy bag over the stoma, ensuring the stoma is centered within the hole. Peel the paper off the ring seal. Now sprinkle stoma pasta around the stoma. Place the seal evenly around the stoma. Gently press around the adhesive to secure it in place. If you have a warm cloth, try to hold the cloth over the seal to ensure a good stick.
Step 8: Check the Seal
After applying the new bag, check for a secure attachment and a proper seal. Gently press around the adhesive to ensure it is well-secured and there are no potential leak points.
Step 9: Wash Hands and Clean Up
Take off the gloves and dispose of them properly. Now wash your hands with mild soap and water and dry them completely.
Step 10: Document the Change
This is one of the most important steps to maintain your colostomy care record. Note down the date and time of the colostomy bag change in your colostomy care record book. Keeping a record of bag changes helps in monitoring your stoma’s health and managing your supplies effectively.
WHEN TO SEE A DOCTOR
Stoma requires proper care and health care attention in the initial few weeks, after that, it can be easily looked after by ostomates. However, some red flags should be addressed properly by visiting your ostomy nurse or doctor. These are:
- When your foul bad smell arises from the stoma and either pus or blood is draining from it.
- You observe some unusual changes in the stoma such as changes in color, change in length, or some cases it getting pulled into your skin.
- When you experience bulging in peristomal skin.
- you have unbearable pain in your belly
- You did not experience any bowel movement for the last 4 hours.
These are the signs that clearly give a signal to immediately seek assistance from any healthcare professional.
Being dependent on someone is the worst feeling ever that no ostomates want to experience. That is why changing the colostomy bag is considered as a basic skill for them. To maintain good health and hygiene regular and proper bag changes are crucial. Also, it helps in preventing skin irritation and ensures a high quality of life for individuals with ostomates.