Stoma Resources

The almost quarter of a million people living in the UK with a stoma are likely to encounter damage to the skin around their stoma. Community nurses are well placed to assist in skin assessment and planning of interventions to improve skin integrity if damage does occur. As part of that skin assessment process, it is important to understand the terminology used to identify issues being observed as well as the potential causes. Although general wound healing is similar across different areas of the body, wound healing products used on peristomal skin need to be considered in terms of how they might adversely affect adhesion of the stoma appliance. Sometimes simple changes to diet or skin care routine, which community nurses can suggest, is enough to improve the peristomal skin condition.

It has been reported that one in 500 people in the UK are living with a stoma (Colostomy UK, 2022) and nearly three-quarters of people with a stoma experience skin problems. Therefore, skin assessment, cornerstone of peristomal skin care. This article introduces common peristomal complications, focusing on the assessment and prevention of two distinct groups of peristomal skin damage; peristomal moisture-associated skin damage (PMASD), one of the types of moisture-associated skin damage (MASD), and peristomal medical adhesive-related skin injuries (PMARSI).

In recent years, major advances in both the knowledge and practice of wound care have coincided with an increase in the incidence of wounds, due in part to the ageing UK population as well as the increased prevalence of chronic disease and comorbidities, and a rise in clinical and surgical interventions (Myers, 2004).

The Colostomy Association is a national charity that provides support, reassurance and practical advice to anyone in the UK who has, or is about to have, a colostomy. We are here to help and support patients, their families and carers. Our helpline is manned 24 hours a day by volunteers who all have a stoma. Our wide range of leaflets, quarterly magazine Tidings and closed Facebook group offer information and support to anyone affected by life-changing stoma surgery.

Simply trying to cope can be a challenge for the many people in the UK who have a stoma — this can include issues such as how to clean and maintain the appliance and what to do if there is a complication once they have been discharged home into the community. The community nurse is often the first point of contact when there are problems with a stoma in the patient’s home and may have to advise on how to change a stoma appliance as well as how to deal with issues such as skin stripping and leaking.

Community nurses are frequently involved in the care of patients after they are discharged from hospital, including many who have undergone stoma-forming surgery. There is evidence that it takes some time to adjust to life with a stoma, with much of this adjustment occurring in the first three months following surgery. During this period, nurses can use their skills to resolve any
problems that might occur, helping patients to adapt and improve their quality of life. If community nurses cannot resolve any issues patients may have with their stomas, referral to a specialist such as the local stoma specialist nurse, might be necessary.

Jennie Burch, Enhanced Recovery Nurse, St Marks Hospital, Surgery, Harrow, Middlesex

Linda Readding briefly describes the different types of stoma that may be involved in the management of a patient with colorectal cancer.

Jennie Burch discusses stomas and the reasons for their formation.

Jennie Burch RN, MSc, BSc is an Enhanced Recovery Nurse Facilitator, St Marks Hospital, Middlesex

Article accepted for publication: March 2011

Barbara Borwell discusses how an individual’s ability to deal with the practical features of stoma care will differ, therefore, requiring unpredictable levels of intervention. This article focuses on the principles of stoma care acknowledging the importance of factors, which can enhance the quality of life

Barbara Borwell MA (Ed), RGN, ENB 216, ENB 980, Dip. Counselling, Cert. Psychosexual Counselling & Therapy, NDN Cert. City & Guilds FETC, BCN is an Independent Nurse Consultant/Lecturer, Nationally/Internationally

Article accepted for publication: April 2011