If you have a colostomy bag, you need some time to learn how to replace it without difficulty. The nurse will surely have given you the specific information to perform the procedure before you leave the hospital, but with time and practice you will quickly become an expert in this operation.
Steps
Part 1 of 2: Change the Colostomy Bag
Step 1. Begin by emptying the bag
If there is urine or faeces in the pouch, it is important to empty it before replacing it. The most suitable place for this operation is the bathroom. Open the bottom of the bag on the toilet. As for the feces, you can take them out by gently squeezing the bag; the urine will flow out automatically when you open the bag.
Alternatively, some bags of this type have liners and flanges that are designed to be flushed into the toilet. If the bag you are using has a biodegradable flange and inner liner, place it in the toilet and flush the toilet. The outer layer remains clean. You can put it in a bag or pocket until you have a chance to throw it away
Step 2. Wash your hands thoroughly with soap and water
If this is not possible, use an alcoholic sanitizer. Place a clean towel on your lap by tucking the top edge into the waist of your pants to protect your clothing. It is important to ensure proper hygiene when replacing the colostomy pouch.
Step 3. Gently peel off the bag
Pull it off slowly using the built-in pull tab that makes it easy to remove and holding the skin with your other hand. If necessary, you can carefully use a product that removes the adhesive to help you with this.
Step 4. Check the skin
It may be slightly red or pink. However, if it appears black, purple, or blue, or if you are concerned about its appearance, seek medical advice. Also check your stoma in general - it should always be flesh-red in color and never dark. If it has changed in size, is protruding or sunken more than usual, oozing pus or blood, or is pale or bluish, call your doctor right away.
Step 5. Clean the stoma
Use warm water, a dry washcloth with mild soap and gently scrub the area around the opening. Don't be too vigorous. Rely only on soaps without fragrances and oils, at the end use a cloth to pat and dry the skin.
- If necessary, use the card your doctor or nurse gave you to assess the size of your stoma. Before attaching the new bag you need to know, if you don't already know it, the size of the opening.
- Remember to wash your hands once more before placing the new bag. This way, the new device will be perfectly sanitized, as the last thing you want is to contaminate it with old fecal residue.
Step 6. Try to use skin protection, such as ostomy powder
This is optional, but many patients use a product not only to protect the skin, but also to provide a perfect base and anchor point for the new bag. Sprinkle the powder all around the opening, making sure it doesn't fall on the stoma itself. Gently spread it using a dry wipe and then wait for the area to dry for about 60 seconds.
Step 7. Prepare the new bag
The plate needs to be modified to fit the opening perfectly. In this case, you need to use special scissors to cut out a circle from the plaque itself.
- The circle must be about 3 mm larger than the stoma, some plates have a pre-printed circumference, which helps in this operation.
- Cut out the plate to fit your stoma.
- It takes some time to master this part of the procedure. Often it is possible to contact the "ostomy clinic" by telephone, where a nurse answers any questions, helps solve problems and / or recommends going to the hospital if the difficulties cannot be resolved by telephone.
Step 8. Put a few drops of baby oil in the bag, being careful not to put it elsewhere
- This step is useful for when the time comes to remove the stool from the pouch. The oil prevents the stool from sticking to the walls of the pouch.
- Buying or reusing a bottle with the dropper could be very useful for this operation.
Step 9. Place the plate on the stoma
Start by pressing the part under the opening, then gently move to the sides and top. When it is perfectly adherent, smooth the surface of the plate to eliminate any wrinkles. By doing so, you create a perfect seal around the opening.
- Start in the center, near the stoma, and move towards the outer edges. You have to smooth out all the folds, otherwise the bag may have leaks.
- When changing the plaque of a two-piece bag, you must use ostomy paste or a sealing ring as an adhesive.
- Gently press the plate for about 45 seconds. The warmth of the hands helps the adhesive to stick to the skin.
Part 2 of 2: Preparing for the Procedure
Step 1. Know when to replace the bag
The frequency of changes depends on your needs and the model of the device. People using one-piece models have to change the entire bag every time, while patients with two-piece devices can replace it whenever they want; the plaque can instead be kept in place for two or three days.
- You shouldn't have to wait more than seven days between changing the bag and changing the plate.
- Remember that these directions are just guidelines. Always follow the instructions your doctor or nurse has given you regarding the frequency of replacements.
Step 2. Purchase the suitable device
When you are discharged from the hospital, the ostomy nurse makes sure you have all the specific materials and the correct information so that you can get the right parts for you when you run out of supplies. Many orthopedics and medical device stores deliver ostomy supplies directly to the patient's home, making the task easier.
Make sure you have good supplies so you don't run out of supplies when changing the bag
Step 3. Take off your shirt and put everything you need together
It is better to take off your shirt, to avoid it getting in the way of operations. Before you begin, make sure everything you need is close at hand. Typically, you need:
- A new bag;
- A clean cloth;
- A plastic bag;
- Skin wipes or cleaning materials;
- Scissors;
- A card to measure the stoma and a pen;
- Skin protection, such as ostomy powder (optional)
- Adhesive material (usually a ring or stoma paste).
- An additional bag, in case you need it.
Advice
- A two-piece openable device allows for frequent bag changes, while the plate can only be changed once or twice a week. Although it is possible to replace the pouch at any time, most ostomate patients prefer to change it after each bowel movement.
- It is often possible to cut the circle of the plate in advance, according to the size of the opening, to avoid wasting too much time on measurements when removing and replacing the device.
