An ostomy wound, also known as a stoma, is a surgical opening linking internal organs to the outside. These wounds are used for a variety of purposes ranging from delivering nutrition directly to the stomach to providing drainage for a patient with a damaged bladder. They can be temporary or permanent and special wound care procedures are required to keep the site of the ostomy wound clean and healthy while preventing the opening from closing prematurely.
An ostomy may be used temporarily to allow a patient's body to recover, as seen when patients have surgery on their bowels and a stoma is created to temporarily bypass the surgical site, giving it time to heal. Similar surgical sites are created for people recovering from procedures on the bladder. In other cases, an ostomy wound may be a permanent necessity. People who lose their colons to cancer, for example, will need a colostomy to drain their intestinal tracts.
The wound is created in an operating room by a skilled surgeon who selects the best placement. The patient is usually placed under general anesthesia for the procedure. Part of the surgery will include placing a tube and a button to hold the tube in place so that the ostomy wound will not close up. A common problem with such wounds is that the body regards them as abnormal and will attempt to heal closed if the drainage tubes are pulled out or out of position.
In the initial days after a surgery to create a stoma, special care is needed. The surgical site has to be kept scrupulously clean and any signs of infection or inflammation need to be addressed promptly. As the patient heals, wound care requirements decrease, although it is still important to keep the ostomy sealed or connected to a drainage bag. In addition, the opening needs to be covered with protective bandaging to reduce the risk of colonization by dangerous bacteria and other microorganisms.
A patient with a permanent stoma will be provided with careful wound care instructions and will be required to attend periodic followups to confirm that the site is still healthy and still functioning as needed. Patients with temporary ostomy wounds may receive hospital care from a wound care specialist. If they are sent home while the ostomy wound is still in place, they can be provided with information about how to take care of it and may also work with a home health provider during their recovery.