Stomal Care

Chapter 15: Stomal Care 

Overview:

• Informs about the types of stomas using explanations and diagrammatic representations
• Discusses pre-operative and post-operative care options
• Includes a tabulated summary for the routine observation of new stomas
• Provides guidelines for selecting an appliance
• Includes a tabulated summary of the commonly used stomal accessories and pharmaceuticals
• Suggests methods in changing an appliance
• Assesses common concerns accompanying women with a stoma including; diet, sexual function, constipation and diarrhoea

Description:

Women with gynaecological cancer sometimes require stomas as a result of surgery for tumour removal or reduction, or as a result of progression and complications of a tumour (including obstruction, invasion, and erosion). If the underlying problem cannot be cured, a palliative stoma might be required to make the woman more comfortable. This chapter explores the role of stomas in the care of women with gynaecological cancer.

Topics:

• Types of stomas
• Use of stomas in gynaecological cancer
  • Ovarian cancer
  • Radiotherapy
  • Rectovaginal and vesicovaginal fistulas
  • Pelvic exenteration
• Pre-operative care
  • Education and counselling
  • Stoma site selection and marking
• Post-operative care
  • Bowel stomas
  • Urinary stomas
• Selecting an appliance
  • Type of bag
  • One-piece or two-piece
  • Flat or convex
  • Composition of part attached to skin
  • Size and shape of the stoma
  • Opaque and transparent bags
  • Size and shape of patient
• Skin care
• Changing the appliance
• Diet
  • Colostomy
  • Ileostomy
  • Urostomy
• Sexual function
• Colostomy irrigation
• Constipation and diarrhoea
• Before discharge from hospital

Speaker / Author:

Julia Thompson
Julia is a registered nurse who holds post-basic certificates in cardiothoracic and stomal therapy nursing, a diploma in nurse education, a bachelor of arts degree (psychology), a graduate certificate in advanced clinical nursing, and a PhD. Her doctoral treatise focused on patient and nurse collaboration in long-term management of newly formed colostomies. Since 1978 most of Julia’s work has been in stomal therapy as a Clinical Nurse Consultant and senior lecturer. She is now the Clinical Nurse Consultant in stomal therapy and palliative care at St Vincents Private Hospital (Sydney, Australia).

Julia is a Fellow of the College of Nursing. She is a member of editorial boards for the Journal of Stomal Therapy Australia and the Journal of the World Council of Enterostomal Therapists (WCET). Julia was honorary editor of the WCET Journal and an executive board member of WCET for six years. She is a writer, marker, and tutor for the distance education graduate certificate in stomal therapy nursing run by the College of Nursing. Julia has published more than 40 papers and authored six patient education booklets and several videotapes. She has spoken at more than 50 National and International conferences and frequently organises seminars on stomal therapy.

Professional Reviews: