Colostomy is done for diversion of bowel. A colostomy is a category of stoma in which the colon can be exteriorized. This may be done to relieve an obstruction and to prevent the remaining bowel from contamination. It may be temporary, depending on the indication for which it is performed. Most stomachaches are incontinent. This makes healthcare a mandatory procedure after colostomy. 

It is an all-encompassing term referring to colostomy management, from its creation to management, to appliance application and mental health while dealing with it. The purpose of it is for skin protection and care for subject acceptance and to avoid stoma related complications. They are generally made in the anterior abdominal wall over the rectus abdominis muscle. Occasionally the site is cephalad to the umbilicus, particularly in fatty patients, as the anterior wall has less subcutaneous fat in the upper portion. 

During the surgical procedure, an incision is made over the pre-identified stoma site. It requires a flat surface on the abdomen with 2 to 3 inches and should be away from the beltline, as well as bony prominences for a secure seal of the stoma appliance. The incision is deepened onto the rectus sheath, which is incised. It is a plastic bag that collects matter from the digestive tract via an opening in the abdominal wall known as stoma. 

Medical professionals attach a bag to the stoma following an operation. During this medical procedure, the surgeon will bring out a portion of the large intestine via stoma. This bag can then collect stool as it passes through. A subject needs a colostomy due to injury or disease with the lower bowels. In some cases, it is temporary. In other situations, such as the removal of the colon because of cancer, it may be permanent.

MANAGING A COLOSTOMY USING THE EQUIPMENT

Managing a surgical colostomy is performed by a nurse or by a therapist, but providers should be aware of the condition of the stoma. There are different types of colostomy kits available, depending on the type of stoma. The 2-piece one consists of a base-plate attached to the biological skin with a removable bag. Although it is very durable, it requires an amount of skill to use and has a weaker adhesive as well. The one-piece one consists of a single unit wherein the barrier and the pouch are connected. It is simpler to use but must be replaced occasionally. The closed pouch type is generally used by subjects who have a constant elimination problem and have to be discarded after one time use. 

The open-ended types are also commonly used and consist of a single piece system attached to the native skin around the stoma with a pouch and can be left attached while removing content. A closed bag must be required, unless the content is mostly fluid, when a drainable one may also be used. In an end colostomy type, colostomy plug can also be used. Bags of different sizes are available, and they may be used by different people at different times during different activities. Pediatric sized  bags are also available. 

COMPLICATIONS OF COLOSTOMIES DURING THE SURGICAL PROCEDURES

Healthcare providers should monitor stomas at regular intervals to look for the multiple complications. Some complications after surgery are extremely troublesome. Minor troublesome complaints of the patient include unpleasant smell, the repeated requirement of draining, or repeated leakage. 

Unpleasant smells can be managed by deodorants or high quality colostomy bags from trusted hospital equipment manufacturers or avoidance of food like fish and onions that release such odors. Leakage bags can be prevented by preoperative site marking and counseling in the postoperative time. Severe complaints include pain and skin excoriation, stomal diarrhea and requirement for colostomy irrigation. 

Skin excoriation can be managed by application of creams, with the application of the right size of the cut end on the back of the baseplate. Regular change of appliances should be done, with the removal of the older bag. Colostomy diarrhea is also complained by the patient in case of transverse colostomies in case they are not fully explained, but stomal one may be the result of extensive resection with failure of bowel adaptation. It may also be due to infectious causes like bacterial overgrowth and clostridium difficile enteritis. In the case of stoma constipation, obstruction should be ruled out by checking for absent bowel sounds.

CONCLUSION

Thus, colostomy is one of the common surgeries performed by a surgeon and is done for diversion of the remaining bowel and to protect anastomosis. The most common type is an end colostomy after some specific procedure. It is done through an integrated multidisciplinary approach. It involves preoperative marking and psychosocial counseling for ileus and stromal edema, and application of bags. 

Also, it is advisable to teach patients about proper bag application and looking out for stoma related complications by the patient and therapist in the late postoperative time. People use these bags when they have a permanent or temporary condition. 

Colostomies are used when something injuries and damages a person’s lower bowels. These are widespread and do not interfere with other activities. People should discuss their kit options with their medical team to find the system that works best for them. Many different types and sizes are used, so a person should be able to find one that fits their demands.