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New Ostomate?

Before surgery
Stoma surgery can be scary, but you’re in good company. We can help you get ready physically and mentally..

If you are facing stoma surgery, you have a medical condition or injury that is stopping your bowel or bladder from working properly. But you’re not alone. There are at least 1.3 million people today, of all ages and backgrounds, living active productive lives with a stoma and approximately 110,000 in South Africa.

Stoma surgery is life changing in many ways. Like any major surgery, it can also be nerve-wracking—for you and your loved ones. The process of feeling comfortable living with your stoma starts with understanding the procedure and what questions you should ask your healthcare team before surgery. We’re here to help you—now and every step of the way on your stoma journey.

I this section there is lots of advice, however please do feel free to call us if that works for you. We are here to help, and if we can’t we will point you in the right direction – 0861 888 842

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Surgery can improve your life

Depending upon your needs, the surgery will remove the part of your bladder (urostomy), small intestine (ileostomy) or large intestine (colostomy) that is too damaged by your medical condition to recover on its own.

During the procedure, your surgeon will also create a stoma, an opening on the outside of your abdomen for waste materials to leave your body. Your stoma will, in most cases, improve your general health and get you back to living a full life.

What is a stoma?

When you have stoma surgery, an opening called a stoma is created in the abdomen (belly). Your stoma provides an alternate way for waste materials to leave your body. The location of the stoma depends upon the type of surgery you need.

Common reasons for a stoma, including:
  • Colon, bladder or rectal cancer
  • Inflammatory bowel diseases, such as Crohn’s disease or ulcerative colitis
  • Inherited conditions, such as familial adenomatous polyposis (a type of colorectal cancer passed down through families)
  • Birth anomalies
  • Penetrative wounds and other trauma to the abdomen
  • Spina bifida or other congenital conditions
  • Obstruction of the ureter

Depending on the disease or wound, a stoma may be temporary (to allow for healing and a return to normal elimination) or permanent. Your doctor will tell you whether your stoma will be temporary or permanent.

Types of Stoma Surgery
  • Colostomy (large intestine)
  • Ileostomy (small intestine)
  • Urostomy (urinary tract)

If you are having a colostomy or ileostomy, you will lose voluntary control of your bowel movements. If you are having a urostomy, you will not be able to control urination. These elimination processes will be contained by a discreet pouching system attached to your abdomen. Different pouching systems are available for different lifestyle needs.

Colostomy Surgery

A colostomy is created out of the end of the large intestine to divert waste from your digestive system. After you have this surgery, you will pass waste through a stoma that is located on your abdomen.

The location of your colostomy is determined by the location of the damaged portion of your colon or to divert stool from a wound in the perianal area. The pictures below demonstrate the different areas in which a colostomy can be placed. Depending on placement and reason for the stoma, these can be permanent or temporary.

Ileostomy Surgery

An ileostomy is created out of the ileum (small intestine)1 and requires some particular but simple attention to keep you comfortable and healthy.

Because the ileum contains digestive enzymes and acids that may cause skin irritation, extra care is needed with an ileostomy to keep waste materials from coming into contact with the skin on your abdomen.

Having an ileostomy may make you more prone to dehydration, which could lead to the loss of important minerals your body needs.3 Speak to your Stoma Care Nurse for advice and supplements to help keep you hydrated.

Urostomy Surgery

A urostomy is a type of surgery which enables urine to exit the body through a stoma after removal of a diseased or damaged portion of your urinary tract. With a urostomy, urine flows through your stoma as it is produced, so a pouching system is necessary. All urostomy pouches have a drainage tap on the bottom, allowing you to empty the contents of the pouch repeatedly throughout the day.

Ileal Conduit

An ileal conduit is a common type of urostomy. If you need an ileal conduit, your bladder must be removed due to disease or injury.

In this surgery, a part of the small intestine is cut and clamped shut at one end. This creates a new urine container or “bladder.” The two ureters (tubes) that carry urine from the kidneys are attached to this new bladder and the open end of the new bladder is then brought out through your abdominal wall, to create a stoma.

Ureterostomy

In an ureterostomy, one or both ureters (urine tubes) are redirected from the kidney through the abdominal wall to form a stoma.

This is a very rare procedure. This type of surgery is most often seen as a temporary measure in some paediatric patients, and is rarely meant to be permanent.

How is a stoma created?

A stoma is a portion of your large or small intestine or urinary tract that has been brought through the surface of your abdomen (belly) and then folded back. The location depends on your medical condition. A stoma provides an alternative path for urine (in the case of a urostomy) or stool (in the case of a colostomy or ileostomy) to leave your body.

All stomas are not created equal. They vary in size, shape, location and construction.

  • End stoma: the bowel is cut, and the working end is brought through the abdomen to the skin surface
  • Loop stoma: a loop of the bowel is brought through the abdomen to the skin surface and temporarily supported by a plastic bridge or rod
  • Double-barrel stoma: the ends of the bowel are brought through the abdomen to the skin surface as two separate stomas

Depending on the reason for your stoma, your surgeon will decide which kind of stoma is best for you. Like you, every stoma is unique. Taking good care of your stoma by selecting a pouching system and routine that fits your lifestyle is critical for your comfort and health. When fitted correctly and taken care of properly, pouching systems help you return to a more active life.

What to expect.

Your professional healthcare team is your best resource for answering all your questions and getting you back to the life you love. Below, discover their roles in your recovery, as well as some questions to consider asking when you meet with them.

When you see your surgeon before your operation, he or she will discuss which type of stoma is best for you. This will depend on the type of surgery you need. He or she will also discuss whether the stoma is going to be temporary or permanent. At that visit, your surgeon may also give you the name of a stoma care nurse.

Your stoma care nurse

A specialised stoma care nurse is a partner, guide and teacher in your stoma journey. As you adjust to life with a stoma, your nurse will be your go-to person.

If you are able to meet with a nurse before your surgery, he or she will help you prepare for surgery and adjust to life with a stoma. At this pre-surgery visit, your nurse will find out as much as possible about your individual lifestyle and needs. From this discussion, your nurse and surgeon will recommend the best position for your stoma. Then at the time of your surgery, the nurse will mark this position on your abdomen (belly) so that the surgeon can see where to form the stoma.

If you would like to meet with someone who has had a stoma, your nurse may be able to make arrangements. If you need some help connecting with a Stoma nurse, call Umsinsi Heath care on 0861 888 842 or you can contact the South Africa Stomaltherapy Association 021 472 6409 from, South Africa or find them at www.stoma.co.za. They can put you in touch with someone either in your area or an alternate healthcare professional who can provide you with the guidance you need.

Choose an appropriate stoma placement

The first step in preventive care starts with the selection of the best place for your stoma. A poorly placed stoma can cause the pouching system to fail, in addition to causing skin and leakage problems.

If time permits, it is important to discuss the placement of your stoma with your surgeon. Depending on your medical condition or injury, this may happen either at your surgeon’s office or at the hospital. Here are some important guidelines that should be followed:

  • The stoma site should be viewable and easily reached so that you can manage pouching changes on your own.
  • Ideally, the stoma should not be placed near or around skin folds, scars or bony prominences, so that the pouching system can adhere flat to the skin.
  • Placement should be evaluated in sitting, standing and bending positions.
Other questions you may want to ask

Facing surgery can be difficult and stressful, and you might not remember all the questions you have during your pre-surgery appointments. Writing down a list of questions and bringing that list with you to these appointments can help you feel assured that all of your concerns are being addressed.

If possible, it’s also smart to bring a trusted friend or family member with you to your appointments, to take notes and offer support.

Here are some common questions for people facing stoma surgery:

  • Describe my stoma to me (height, position, size, appearance). What should I expect?
  • Will my stoma be permanent or temporary?
  • How does the stoma work?
  • Will my stoma be visible under my clothes?
  • What does a pouch look like (size, types, colours, style)?
  • How do I change the pouch?
  • Will the pouch leak?
  • Where do I get supplies?
  • Will I have to change my diet?
  • When can I go back to work?
  • Will I be able to go out with family and friends?
  • How will my stoma affect my sex life?
  • Will I be able to travel?
  • Where can I get extra help and support?
  • Will I need any special care when I get home from the hospital?

NB Stoma placement may also be discussed in your pre-surgery visit. If your surgeon does not discuss stoma placement with you, we encourage you to ask about it before surgery.

Correct stoma placement is important for your future comfort and ability to take care of your stoma. To manage pouch changes as easily and independently as possible, you will want to make sure the stoma is put on a smooth skin surface and that you can easily see and reach the stoma.

Questions you might want to ask

Here are some common questions you may choose to ask your healthcare professional while you are in the hospital:

  • How soon will I be able to eat and drink?
  • How long will I be in the hospital?
  • What do I do if I am in pain?
  • Does everyone with a stoma need to use a pouch?
  • Who will show me how to use my equipment?
  • Where do I get supplies?

After your surgery, your stoma care nurse will talk to you about the operation, help you understand what has happened to your body, and teach you how to manage your new stoma as you recover in the hospital and transition to home care. Depending on your needs, you may also get referrals to other specialists or clinics for more help.

It is important to remember that everyone is different, and we all adapt to change in different ways. The support you can expect to receive from your nurse will always be geared toward your individual needs. There are many people like you who have had the same operation, and your doctors and nurses are there to listen and help.

Right after surgery
Now what?

Your stoma surgery is finished, and you are at home. For many people, surgery can be the beginning of a more comfortable life. But it still requires adjusting to life with a stoma—physically and mentally.

Although your stoma surgery is complete, you may still have many questions and concerns—particularly during the first 12 weeks of living with a stoma. You may feel nervous, confused or angry. You may be excited by the freedom, improved health and new activities you can enjoy after healing from your surgery. Or you may have a mixture of these emotions. All of these reactions are perfectly normal.

You are not alone. Your stoma care nurse, healthcare professionals and the team at Umsinsi Health Care are there to help you every step of the way.

During the first few months after stoma surgery, it is important to recognize that you and your loved ones will be undergoing a major period of adjustment. Having a stoma means you must adapt to a new “normal” way of life.

Whether you have had a colostomy, ileostomy or urostomy, you will need to learn how to manage the passage of body waste through your stoma, as well as how to care for the skin around your stoma.

For the first six to eight weeks, your stoma will most likely shrink in size. Regular measuring of your stoma ensures you are wearing the correct pouching system size, increases your confidence, and reduces discomfort.

Over time, you will feel much more comfortable with your new lifestyle as stoma management becomes just another part of your daily routine. During this initial adjustment period, however, keep in close contact with your stoma care nurse. The answers to any problems or concerns are usually just a phone call away. If you have any questions at all, please feel free to call the Umsinsi team on 0861 888 842.

Living with a Ostomy

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Understanding Your Stoma

Just like you, each stoma is one-of-a-kind. Stomas vary in size and can be round, oval or irregular in shape. It may protrude or stay flat against your skin.

Stomas do have some similarities. All stomas should be shiny, wet and red in colour, similar to the inside of your mouth. A stoma does not have nerve endings; therefore, it does not transmit pain or other sensations. However, it has many blood vessels and may bleed slightly if irritated or rubbed. This is normal, but if bleeding is prolonged or if you have bloody discharge from your stoma, be sure to contact your healthcare professional.

Selecting the best pouching system depends on your stoma type and the particular physical characteristics of your stoma. You are very welcome to call us for advice, and if we cant help we will know someone who can! 0861 888 842

Skin Care Tips

Having a peristomal (around the stoma) skin complication is one of the most common reasons people living with a stoma seek medical attention. Urine and feces can be irritating to the skin. That’s why a Skin Barrier or adhesive is essential in preventing peristomal skin damage.

Click below to learn how to keep your peristomal skin healthy. If you believe you have a peristomal skin complication, contact your healthcare professional as soon as possible.

Nutritional Advice and Diet Tips

Eating

There are no set dietary rules for people living with a stoma. It may just take a bit of time to find out what works for you.

With the “OK” from your healthcare team, you can eat what you like, when you like. Here are some general guidelines:

  • Eat regularly
  • Drink plenty of fluids
  • To avoid blockages 1,chew your food well
  • Ask your stoma care nurse or a dietician if you need to take vitamins
  • After surgery, try new foods one at a time, in small quantities. If there is a problem (such as gas), you can make simple adjustments that work for you.
  • Most importantly, enjoy your food!

Me+ Services and care (TBC)

Coming soon!

Selecting an Ostomy system

The first step in caring for your stoma is selecting the best stoma system for your unique needs and lifestyle.

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One-Piece System

In a one-piece system, the pouch and Skin Barrier are a single unit. Designed for discretion, these systems offer simplicity and flexibility in a low-profile system. They are available in cut-to-fit and pre-cut adhesive types.

Traditional Two-Piece System

In a two-piece system, the pouch and Wafer/Skin Barrier are two separate pieces that allow you to change the pouch without removing the Wafer/Skin Barrier. With this system, the pouch and Skin Barrier are coupled together with a plastic ring. You can hear and feel the system securely lock into place.

ConvaTec’s traditional SUR-FIT Natura® two-piece system offers a variety of drainable, closed-end and urostomy pouches. Stomahesive® or Durahesive® Wafer/Skin Barrier are designed to protect peristomal skin.

Basic application

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Choosing the Right Size

After surgery, your stoma may be swollen. As it heals, your stoma will gradually shrink in size. Because of this change in the weeks following surgery, it is important to regularly measure your stoma to ensure you are wearing the appropriate pouch size. Your stoma care nurse can help you measure your stoma and advise on resizing needs.

What is a Wafer (Also known as a Skin Barrier)?

A Skin Barrier adheres to your peristomal (around the stoma) skin, helping protect your skin from stoma output, and attaching the pouch to your body.

In a two-piece system, the Skin Barrier is separate from the pouch; in a one-piece system they are combined together.

Basplate include:

  • Standard wear: Best for colostomy.
  • Extended wear: Designed to provide greater protection from stoma output for people living with an ileostomy or urostomy as output can cause skin irritation.

Wafer (Skin Barrier) openings vary in fashion, including:

  • Cut-to-fit: Can be cut to accommodate your unique stoma size.
  • Pre-cut: Available in a wide variety of sizes to accommodate your stoma, without the need for cutting.
  • Mouldable: By moulding around the stoma, this skin barrier creates a snug fit designed to provide greater leakage protection than traditional Skin Barriers.

ConvaTec Skin Barriers come in the following varieties:

One-piece adhesive systems

Two-piece adhesive Skin Barrier

What is a Pouch?

A pouch system collects your urine or faeces, depending on your type of stoma surgery. In a two-piece system, the Skin Barrier is separate from the pouch; in a one-piece system they are combined together. Pouch types may include:

Closed-end pouches

  • Closed-end pouches are designed for one-time usage, which makes them ideal for special occasions and intimate moments. Some people also prefer them for everyday use. There is no draining or clip to worry about. When the pouch is used, you simply remove it, place it into a disposable bag, and discard.
  • Most closed-end pouches come with a filter that is designed to reduce odor and gas buildup.
  • These pouches are recommended for colostomy (everyday use for some; special occasions for anyone) and ileostomy (special occasions). They are not recommended for urostomy.

Drainable pouches

  • Some people may prefer rinse-and-reuse drainable pouches. These pouches are drained simply by releasing the clip at the bottom of the pouch, allowing for quick and easy maintenance.
  • These pouches are recommended for ileostomy and colostomy.

Urostomy Pouches

  • Urostomy pouches are available in one- and two-piece systems. But, unlike colostomy/ileostomy systems, urostomy pouches have a drainable tap instead of a clip. ConvaTec offers a choice of two types of taps: the Accuseal® Tap with valve or fold-up tap, which allow for easy drainage.

Finding the Right Skin Barrier

Keeping your peristomal (around the stoma) skin healthy is important for your health and comfort; however, this skin can become irritated and infected if pouches leak, allowing urine or stool to come into contact with the skin.

A well-fitting Skin Barrier is your best defence against skin complications. Skin Barriers provide the necessary wall between your skin and stoma output, allowing you to remain secure, comfortable and irritation-free.

To ensure the best fit between your Skin Barrier and stoma, make sure you monitor changes in your stoma’s size and shape. As your stoma changes, you may need to adjust the size of your Skin Barrier and pouching system, or switch to a new system or Skin Barrier. Your stoma care nurse can help you set up a measuring routine and also assist with any necessary size or system changes.

Traditional Two-Piece and Adhesive Coupling Technology™ Skin Barrier Options

Stomahesive® Skin Barriers for standard are designed to:

  • Offer reliable peristomal skin protection.
  • Adhere to dry and wet skin.
  • Be comfortable on the skin during wear and gentle to skin upon removal.

Suggested for people with a colostomy, whose stool is solid.

Durahesive® Skin Barriers for extended wear are designed to:

  • Be highly durable and resistant to liquid output.
  • Designed to “turtleneck,” to help prevent leaks and help to provide added skin protection.
  • Be flexible.

Suggested for people with a urostomy or an ileostomy, whose stoma output is liquid to semi-liquid and/or high output. Also suggested for people with a colostomy when stoma output is a liquid consistency.

One-Piece Adhesive Options

ConvaTec one-piece systems feature modified versions of our Stomahesive® and Durahesive® technologies that are:

  • Thinner and more flexible than the Skin Barrier in a two-piece system.
  • Designed for more frequent pouching system changes, with less risk of harming the peristomal skin upon removal.
Basic application of a Stoma System

Here are some basic guidelines for applying your pouching system. For complete instructions, please refer to the product insert or talk to your stoma care nurse.

One-Piece Systems

This system type combines both the Skin Barrier and pouch into one convenient unit.

  • Clean and dry peristomal skin.
  • Measure your stoma.
  • Prepare the Skin Barrier.- For cut-to-fit Skin Barriers: Using the guidelines, cut an appropriate size.
  • Remove the paper from the adhesive.
  • Gently place the pouching system over your stoma.
  • Press the Skin Barrier against the skin, paying particular attention to the area closest to the stoma.
  • Smooth onto your skin. Maintain slight pressure on the Skin Barrier for 30-60 seconds to ensure a good seal.

Remove the release paper from the Skin Barrier.

Place the pouching system gently in position over the stoma. Press the Skin Barrier against the skin, paying particular attention to the area closest to the stoma.

During application, maintain slight pressure on the Skin Barrier for 30 seconds to a minute.

Traditional Two-Piece Systems

This system is made up of both a Skin Barrier and a pouch. The two pieces connect together with a plastic coupling ring.

  • Clean and dry peristomal skin.
  • Measure your stoma.
  • Prepare the Skin Barrier. – For cut-to-fit Skin Barrier: Using the guidelines, cut an appropriate size. – For mouldable Skin Barrier: Roll the adhesive back to fit your stoma.
  • Remove the paper from the adhesive.
  • Center the hole over your stoma, onto your skin.
  • Press the Skin Barrier gently against your skin. Align the plastic ring on the pouch with the ring on the Skin Barrier and press together. You should hear and feel the system locking together.

Place the Skin Barrier gently over the stoma and press it firmly against the skin with attention to the area closest to the stoma.

Position the flange on the pouch over the Skin Barrier flange. Gently press the bottom of the pouch flange against the Skin Barrier and move upward.

Remove the white release paper and centre the hole over the stoma.

Fold the adhesive ring, apply the lower half to the bottom of the landing zone, then roll or slide the fingers to secure the pouch.

Run a finger around the pouch to make sure it’s smooth and wrinkle free.

Finding the right skin barrier

Keeping your peristomal (around the stoma) skin healthy is important for your health and comfort; however, this skin can become irritated and infected if pouches leak, allowing urine or stool to come into contact with the skin.

A well-fitting skin barrier is your best defense against skin complications. Skin barriers provide the necessary wall between your skin and stoma output, allowing you to remain secure, comfortable and irritation-free.

To ensure the best fit between your skin barrier and stoma, make sure you monitor changes in your stoma’s size and shape. As your stoma changes, you may need to adjust the size of your skin barrier and pouching system, or switch to a new system or skin barrier. Your ostomy nurse can help you set up a measuring routine and also assist with any necessary size or system changes.

Traditional Two-Piece and Adhesive Coupling Technology™ Two-Piece Skin Barrier Options

Stomahesive® Skin Barriers for standard are designed to:

  • Offer Reliable peristomal skin protection.
  • Adhere to dry and wet skin.
  • Be comfortable on the skin during wear and gentle to skin upon removable.

Suggested for people with a colostomy, whose stool is semi-formed to formed

Durahesive® Skin Barriers for extended wear are designed to:

    • Be highly durable and resistant to liquid output.
    • Designed to “turtleneck,” to help prevent leaks and help to provide added skin protection.
    • Be flexible.

Suggested for people with a urostomy or an ileostomy, whose stoma output is liquid to semi-liquid and/or high output. Also suggested for people with a colostomy when stoma output is a liquid consistency.

One-Piece Adhesive Options

ConvaTec one-piece systems feature modified versions of our Stomahesive® and Durahesive® technologies that are:

      • Thinner and more flexible than the skin barrier in a two-piece system.
      • Designed for more frequent pouching system changes, with less risk of harming the peristomal skin upon removal.