Care of a Stoma and Changing the Pouch

Procedure

1. Check the type of stoma and the usual output, and choose a quiet time when output is least.
2. Explain the procedure, provide privacy and involve the patient in looking at the stoma.
3. Wash hands, don gloves and gather the new pouch, measuring guide, scissors, wipes, warm water and a disposal bag.
4. Empty the used pouch, then remove it gently from top to bottom, supporting the skin.
5. Clean the stoma and peristomal skin with warm water and gauze only — no soap, antiseptic or alcohol.
6. Assess the stoma: colour should be pink or red and moist; report any dusky, black or retracted stoma at once.
7. Assess the peristomal skin for excoriation, leakage tracks, rash or bleeding.
8. Measure the stoma, cut the flange no more than 2–3 mm larger than the stoma.
9. Dry the skin thoroughly, apply the flange from the base upward and hold with a warm hand for 30 seconds.
10. Attach and close the pouch, dispose of waste, and record the stoma appearance, output and skin condition.