SWCCAC Wound Management Program
Name: Date:
I need to change my appliance: ____ x per week and/or ______
The best time to change it is in the morning before breakfast or drinking fluids.
Steps / Changing the ApplianceStep 1
Collect all of the supplies that you need. / Unsterile Gloves (not necessary unless you prefer) Garbage bag
Clean washcloth Clean hand towel Toilet or facial tissues
Disposable J-cloth Mirror for vanity or behind door
Pouching Supplies: Barrier/ Flange + Pouch or One piece pouch
Accessories: Barrier wipe Stoma paste Barrier Ring or Paste Strip Adhesive remover wipe Ostomy powder Ostomy belt
Other:
Wash your hands with soap for 15 seconds and dry them.
Open the packages that you will need, but leave the paper or plastic backing on the barrier/flange.
Follow the “Skin Care” instructions in your “My ____ostomy” booklet, or other instructions your ET or Ostomy resource nurse has given you.
Step 2
Remove the old appliance. / Press gently on the skin around your stoma with 1 hand,holding the system with the other hand, whileloosening the taped edge of the appliance, and then the skin barrier.
If it is painful to loosen the tape and barrier, use an adhesive remover wipe to help break the adhesive seal. You should be able to stop using this in few weeks, when you have less discomfort.
Start at the top, and leave the pouch attached so that any ostomy output will go intothe pouch. You can tuck an old hand towel into your pants so that it protects your clothes and is handy if needed
Step 3
Wash and Dry the skin / Gently wash around the stoma with a washcloth and lukewarm water (DO NOT use Soap). If you shower, and choose to remove the barrier/flange during the shower or before, be sure to rinse the area well with water to remove any soap film. Soap can leave the skin oily, or cause sensitivity and rash.
Pat dry, and check your skin for any redness or open areas.
The skin should be clear and free from any irritation, and should look like the skin on the opposite side of your abdomen.
If not,the nurse should check your pouching system and skin.
If there are small moist open areas, you can apply a small amount of ostomy powder and dust off the extra.
If you touch the stoma with a dry tissue or paper towel, or even with the dampened tissue, you may notice a small amount of bleeding that will stop almost instantly—this is normal.
Step 4
Shave the skin / You may need to do this once or twice a week, or not at all.
Follow the “Skin Care” instructions in your “My ____ostomy” booklet, or other instructions your ET or Ostomy resource nurse has given you.
Step 5
Measure the stoma / If your system is a “cut-to-fit” one, it means that your stoma may still be shrinking after the surgery or is an unusual shape.
Use the measuring card to see how big the opening should be.
You should cut the opening slightly bigger than the stoma size (1/8” or 2 mm larger)- just enough to allow room for the stoma to stretch with movement.
You should leave this much room around the stoma:
If you are using a “moldable” product, you will stretch it to fit, instead of being cut. Your nurse will tell you how to use this.
Step 6
Prepare the equipment / Cut the barrier to the correct size, or use a pre-sized one.
Remove paper or plastic backing. The nurse will write your directions here:
Step 7
Apply the appliance and pouch / Make sure that the skin is still dry. If your stoma is long and sits on the skin, lift it and dry the skin one more time. Centre the barrier over the stoma and apply to the skin. Add the pouch and belt (if using). Wash and dry your hands. If possible, hold the new system in place on your skin x 10 minutes before doing any activities—this helps to warm the adhesives and improves the adhesion to your skin.
Nurse’s NameDate
Signature and Status
Self-Care Teaching Handout: My Ostomy Care - Adapted from CP BPSO Feb 16 2012 Used with permission.
Adapted from Ready…Aim…Improve! Surgical Wounds