1、Uneven skin around the stoma

• Excessive obesity. For obese people, the intestinal tube at the stoma has tension when it opens in the abdominal wall. After the tension of the intestinal tube in the abdominal wall tissue is restored, the skin around the stoma is indented in a circle, causing the skin around the stoma to be uneven.
• The patient was wasting. The abdomen of the wasting patient is sunken, and the stoma is made in the sunken area, resulting in uneven skin around the stoma.
• The stoma is close to the bone protuberance, wound, and belly button. Generally, the intestinal stoma should be located at the rectus abdominis muscle and avoid skin folds, belly buttons, surgical incisions, and bony protrusions.
• Changes in posture. Patients who have gotten out of bed have not observed the skin around the stoma and measured the actual size of the stoma when they are sitting or standing. As a result, the ostomy bag is cut large, or the skin around the stoma is not found.

2、Causes of moist or dry skin around the stoma

• Stool from ileostomy is watery, and it flows as you rub it; in addition, there will be residual stool at the root of the double-cavity stoma; in summer, the weather is humid, and the patient will have a lot of sweat. These conditions can cause the skin around the stoma to be moist.
• The skin is too dry. Excessive spraying of skin care powder around the stoma will cause the chassis to not stick firmly; if the anti-leakage cream itself is too dry, it will also cause dry skin. The anti-leakage cream is routinely applied to the inner ring of the stoma chassis, because it contains ethanol to protect the skin of the stoma. The effect of leakage, if the ethanol evaporates, the anti-leakage paste will be too dry.
• Incomplete cleaning. The skin around the stoma has residues of inflammatory exudate and stoma glue.

3、Improper use of ostomy bag

• Improper choice of ostomy bag.

① The stoma itself is flat or lower than the skin around the stoma. A convex bottom plate should be used to make the stoma protrude so that the stool can drain into the bottom of the bag smoothly and prevent leakage.

② When the diameter of the stoma is> 4.5 cm, choose a one-piece large-chassis ostomy bag to prevent leakage of the ostomy bag. The two-piece ostomy bag is used in the initial stage. If excessive force is used during replacement, it will easily cause the sticking part to fall off and cause leakage.

• Improper cutting of the center hole of the stoma chassis. The cut size of the center hole of the chassis is wrong, and there is a large gap between it and the root of the stoma, which will cause leakage.

4、Improper use of washing pot

• When flushing, rush straight to the edge of the stoma. Water enters from the bottom of the ostomy bag and rushes directly to the edge of the stoma, and the water pressure causes water to enter the gap between the ostomy bag and the skin;
• There is too much water remaining on the edge of the stoma, causing water to enter the gap between the stoma bag and the skin.

5、Irregular stoma position

    The position of the stoma is not standardized due to surgery and other reasons.