You’re teaching Anthony how to use his new colostomy. How much skin should remain exposed between the stoma and the ring of the appliance?
1/16”
1/4”
1/2”
1”
Correct Answer: A. 1/16”
Only a small amount of skin should be exposed and more than 1/16” of skin allows the excrement to irritate the skin. It is expected that the stoma will change its size (get smaller) for the first four to six weeks after surgery due to the swelling that occurs post-op.
Option B: Cut the wafer slightly larger to accommodate the expansion. Doing this also helps to prevent the wafer from “strangulating” the stoma by putting too much pressure around it.
Option C: Make sure that there’s about a 1/16 – 1/8? (approx. 1.5 – 3mm) gap between the stoma and the edge of the hole. Remember, as wafers do swell, the patient may need to adjust this gap accordingly. If using a barrier ring or similar product, it is okay to cut the hole slightly larger
Option D: The pouching system must be completely sealed to prevent leaking of the effluent and to protect the surrounding peristomal skin. The disposable pouching systems can be either a one-piece or a two-piece flexible system consisting of a plastic bag and a flange (skin barrier) that sit against the patient’s skin. The flange may be flat or convex.
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