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Last Updated: Jan 10, 2023
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Defect In Colon - How Colostomy Can Be Of Help?

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Dr. Yoga Nagendhar MPediatric Surgeon • 30 Years Exp.M.Ch - Paediatric Surgery, MBBS, MS - General Surgery
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Colostomies often get used in situations of Imperforate Anus along with other conditions where a paediatrician finds a defect in the colon or in the large intestine.

Selection of Pouch
Pouch systems are available in many styles as well as sizes. They include:

  • A sticky kind of wafer which adheres to the skin and a pouch to collect the stool.
  • One piece pouch has the wafer along with the pouch joined together as a single unit.
  • The two piece system consists of wafer and pouch in a separate manner.
  • There are also open-ended pouches and close-ended pouches
  • Open end pouches are most commonly used as they help people to easily out the pouch of air and stool

Changing the Pouch - Procedure
The frequency, with which the change of pouch takes place, depends upon a number of things. A pouch must be changed after it has been there for a number of days.
The good time to get a pouch changed is before a meal or a number of hours after eating, where there is less of stoma draining.

The procedure involves:

  • Carefully removing the old pouch with mineral oil. Wash and keep the reusable clip aside.
  • A child could be given bath in the tub or shower with the pouch off.
  • Keep an eye on the stoma for changes in size and color. There could a slight bleeding from the stoma.
  • If the stoma is round, make use of the precut template to find a pattern that fits perfectly.
  • A perfect fit means that no skin should be visible around the stoma.
  • In case the stoma is irregular in shape, then use a firm piece of clear plastic to mark a pattern of the stoma.
  • Make use of the template to find an opening on the wafer.
  • Then cut the tracing with sharp scissors
  • Smooth out the rough areas with finger
  • Warm the wafer in the hand to help soften it.
  • Apply Cavilon 3M no sting barrier film to skin around the stoma.
  • If paste is used, it must be applied in a sparing manner to the wafer around the hand cut opening.
  • Press the pouch on the skin by using light pressure with the hand, hence making the attachment secure.
  • Apply clip to the end of pouch.
  • Make the pouch empty once it gets 1/3 filled with air or stool.
  • Change the whole pouch when the wafer becomes loose from the skin.
  • Do not flush the pouch down the toilet.
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