A stoma is a surgically created opening on the abdomen that allows waste to leave the body, diverting the function of the intestines or urinary tract into an external pouch. This opening requires consistent management to maintain skin health and ensure the ostomy appliance adheres properly. Maintaining a clean area around the stoma, known as peristomal skin, is paramount for comfort and preventing complications like irritation or infection. The cleaning process must be gentle, using specific materials and techniques to avoid damaging the delicate skin and mucosal tissue.
Recommended Supplies for Stoma Care
The foundation of safe stoma cleaning rests on using simple, non-irritating materials. The primary and safest cleansing agent is plain, lukewarm tap water. Tap water effectively removes effluent and adhesive residue without introducing chemicals that compromise the integrity of the peristomal skin or the appliance’s adhesion.
Disposable soft supplies are the preferred tools for application, such as non-woven gauze, soft cotton pads, or specialized non-abrasive dry wipes. These materials are designed to be gentle on the skin while absorbing moisture and lifting output. If soap is necessary, it must be a mild, non-scented, and non-moisturizing formulation. Traditional soaps, especially those containing oils, lanolin, or heavy fragrances, leave a residue that interferes with the adhesive barrier, leading to premature appliance failure and leakage.
Avoid several common household products due to their harsh properties. Products containing alcohol, iodine, or oil-based lotions can cause irritation to the sensitive peristomal skin. Baby wipes should also be avoided unless they are specifically formulated to be fragrance-free and residue-free, as many contain moisturizers that hinder the pouching system from sticking securely. Using an adhesive remover (wipe or spray) is appropriate for gently lifting the old barrier and removing residual adhesive, protecting the skin from trauma during removal.
The Gentle Cleaning Process
The cleaning technique begins immediately after the old appliance is gently peeled away, often with the aid of an adhesive remover to prevent skin stripping. Once the adhesive wafer is removed, any solid output remaining on the stoma or surrounding skin should be wiped away with toilet paper or a dry wipe before introducing water. The stoma is made of mucosal tissue, and light spotting of blood during cleaning is common and generally not a cause for concern.
To cleanse the area, use a non-woven wipe or gauze moistened with lukewarm water. Cleaning should be done with a gentle wiping motion, starting immediately next to the stoma and moving outward across the peristomal skin, removing any stool or urine residue. Focus on a soothing touch rather than scrubbing, as friction can easily damage the delicate skin cells. If mild, residue-free soap was used, it must be rinsed off completely using fresh water to ensure no film remains.
Ensuring the peristomal skin is completely dry before applying new products is the most overlooked aspect of the cleaning process. Moisture prevents the hydrocolloid skin barrier from adhering properly, which is the leading cause of leakage and skin damage. Patting the skin dry with a clean, soft cloth or allowing it to air-dry naturally is the best approach to avoid friction. Using a hairdryer on a low, cool setting can help quickly and thoroughly dry the skin, confirming the area is ready for the next steps.
Post-Cleaning Peristomal Skin Protection
After the stoma and surrounding skin are thoroughly cleaned and dry, the next step is preparing the surface for the new adhesive barrier. Peristomal skin protection products create a buffer between the skin and the corrosive stoma output, which is important for ileostomies and urostomies. This preparation involves applying specialized, non-cleansing products that enhance the longevity and security of the pouching system.
A common product is a skin barrier film, available as a wipe or spray, which forms a protective layer over the peristomal area. This film shields the skin from irritation caused by output and minimizes trauma from repeated application and removal of the adhesive wafer. Stoma powder is another specialized product, applied sparingly to moist or irritated skin areas, helping to absorb excess moisture so the adhesive can bond.
For individuals with uneven skin surfaces or creases, a protective barrier ring or paste is often used to fill in gaps. These moldable accessories sit directly against the skin, providing a smooth surface and a tighter seal that prevents effluent from migrating underneath the adhesive wafer. Applying these specialized products before the final pouch ensures maximum skin protection and optimizes the wear time of the ostomy appliance.