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Stoma care - 3 - Changing a 1-piece appliance.

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VOL: 97, ISSUE: 16, PAGE NO: 41

CHRIS METCALF, GASTROENTEROLOGY ENDOSCOPY NURSE SPECIALIST, WEST HERTS NHS TRUST, WATFORD GENERAL HOSPITAL

One-piece pouches are available either as closed or open-ended. They are generally used postoperatively as there are fewer learning stages involved when teaching patients pouch changes than when a two-piece appliance is used. An open-ended pouch is used for both ileostomies and colostomies immediately after surgery for ease of emptying and for patient comfort. A clear pouch enables the nurse to observe the stoma during postoperative recovery, although patients may prefer an opaque one once they are discharged.

One-piece pouches are available either as closed or open-ended. They are generally used postoperatively as there are fewer learning stages involved when teaching patients pouch changes than when a two-piece appliance is used. An open-ended pouch is used for both ileostomies and colostomies immediately after surgery for ease of emptying and for patient comfort. A clear pouch enables the nurse to observe the stoma during postoperative recovery, although patients may prefer an opaque one once they are discharged.

This Part describes how to remove a stoma appliance and apply a new one. A drainable pouch should be emptied before changing it (see Part 2). The skin-protective should be cut to fit snugly around the stoma (see Parts 1a and 1b).

While carrying out the procedure, the patient's pyjama top or nightdress can be clipped out of the way using a clothes peg.

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