1 The essence of the procedure

The location of the colostomy is chosen by the surgeon depending on the localization of the pathological site of the thick intestine. In addition, it is necessary to take into account the state of the outer covers and the walls of the abdominal cavity. If there are different scars and walls, this complicates the process of colostomy.

Many people have developed subcutaneous fat in the transverse line just below the navel sothat this place will be ideal for colostomy. That's why it is installed, as a rule, on the scallop line along the outer edge of the rectus muscles on the abdomen. To take into account the condition of subcutaneous fat is very important, since in the course of time creases will be formed, because of which the colostomy will begin to shift.

When installing a colostomy of the transverse and ascending type, the edge of the opening that extends outwards must be positioned so that it rises above the skin a couple of centimeters. This is due to the elimination of alkaline masses. This arrangement allows you to better fix the calico and protect the tissue around the colostomy from irritation.

Surgical intervention is performed only under general anesthesia in the operating room. Here are the main stages of it:

1. At the place where the artificial hole will be located, you need to make a round cut, while you need to touch and subcutaneous tissue.
2. Muscles near the abdominal wall are supposed to be spread over the fibers. The hole should be large enough in diameter to prevent squeezing of the intestine. Be sure to consider how the trunk will be located in space, whether there are fat deposits.
3. The surgeon then pulls out the colon with his hands and tools.
4. Then the doctor makes a complete or incomplete incision( this depends on the readings), which is carried out transversely.
5. The outer walls of the intestine are fixed to the muscles on the abdomen, and their edges are sewn to the skin.

At the moment, there are no methods of deducing drainage to the lumen of the colostomy, since the protective mechanisms of the body begin to actively resist alien objects, which leads to dystrophic processes and inflammation. So it helps only sewing the edges of the intestine. This will help to heal wounds more quickly.

There are 2 types of colostomy:

1. Temporary. This option is carried out only after partial removal of the thick and direct divisions of the intestine. After the tissues of the operated zones are healed, they are stitched together, and the colostomy is removed. After this, the bowel movement will pass naturally.
2. Constant. This option is prescribed only if the thick part of the intestine and the lower parts of the direct part of the organ are completely removed. Because of this, the body can no longer naturally excrete stool masses.

If the colostomy is temporary, then it can be closed by removing the seams on the skin and separating the surviving areas that were formed during the time of wearing the colostomy( by the way, they are formed a month after the operation).If the type of colostomy is double-barreled, the walls of the intestine are sewn by the usual method. If the colostomy is single-stemmed, a more complicated procedure is necessary, as it is necessary to unite the walls of the intestine with seams and special clips, which then dissolve independently. After the operation, a tightness check is necessary with the help of contrasting.

2 Kinds of calipers

Stomirovanie patients receive a minimum of information, so that they find it difficult to choose a suitable kalopriemnik. But the quality of his life depends on his right choice.

If the patient has a constant colostomy, then it is recommended to use a two-component calorimeter. Its advantage lies in the fact that a person can use different bags - both open and closed type. In this case, they do not injure the skin.

The plate from the bicomponent of a two-component type can stay on the body for about 3-5 days. This frequency of replacement of the stool receptor significantly reduces the load on the skin. In addition, the use of this option greatly facilitates the emptying process. You can just open the bag and clean it. Then wipe the drainage part and again fix it to the plate. If you use a closed bag, you just need to replace it with a new one. By the way, closed-type bags have a built-in carbon filter. It promotes the release of gas, and also neutralizes the smell. When emptying using a two-component calorimeter, you do not need to take an uncomfortable position, as often happens with a one-component version.

With regard to the single-component receptacle, it looks like a bag in which a glue plate is embedded. In this case, you can also use bags of both open and closed type.

3 Care and nourishment for colostomy

For people who first encountered such a phenomenon as colostomy, the most difficult is the emotional realization that now the body's possibilities have changed. People start to consider themselves disabled. But over time, such emotions are replaced by positive ones, since colostomy is carried out in order to facilitate the process of digesting food.

The following rules must be observed:

1. Control the administration of drugs that affect the process of digestion of food, as constipation and diarrhea prevent the excretion of fecal matter through an artificial aperture. So the doctor must always be warned about the presence of colostomy.
2. The diet assumes a complete elimination from the diet of products that contain a large number of proteins of plant origin, as they provoke intense gas formation. For example, this applies to nuts, legumes, cabbage, etc.
3. If any changes in the tissues around the hole are found, you should immediately go to the hospital. It can be redness, the appearance of pain, irritation, discharge of blood, pus, mucus, an unpleasant smell of rot, a feeling of discomfort in the intestine. It is also very important to take into account the cases when the emptying of the intestine becomes irregular.
4. Always ensure that the colostomy is clean and dry. Change plastic bags immediately after they get dirty.
5. It is necessary to avoid heavy physical exertion, especially while the operated tissues have not yet healed. The recovery process can take up to 3 months. All this time a person can feel fatigue and weakness.
6. It is absolutely necessary to replace the kologopriemnik correctly. First, make a hole in a suitably sized bag. Remove the filled calorimeter. Rinse the skin with water and remove dirt. Sometimes you need to use special creams for protection, as well as film, powder and so on. In addition, paste is applied so that the receiver is better attached to the skin.

By colostomy is understood as an operation in which an opening is made in the abdominal wall and a portion of the thick intestine is outwardly drawn to thereby bypass the lower intestinal zones. This process is very important, because it allows the body to get rid of stool. In order to prevent the occurrence of side effects and complications, you must always follow the doctor's instructions.