Maintaining peristomal skin integrity

There are approximately 120,000 people in the UK with a stoma.¹ The three main stoma types are colostomy, ileostomy and urostomy. A stoma should be red or pink in appearance, warm and moist to touch. Ideally, a colostomy should be formed to be slightly above the skin surface whereas an ileostomy or urostomy will have a small spout of about 25mm. Stoma appliances are used to collect and contain the output from the stoma. They are adhered to the skin around the stoma with a special adhesive, in many cases similar to hydrocolloid, thus they are skin-friendly with limited allergies reported. The output from a colostomy is formed faeces and flatus, and is collected into a closed appliance. The colostomy appliance is changed about once daily, although this can range from three times daily to three times a week. An ileostomy will pass flatus and loose faeces that can be described as porridge like. An ileostomy appliance is drainable and fastened most commonly with a Velcro-type fastening. The drainable appliance is emptied about 4–6 times daily and changed between once daily and every three days. A urostomy appliance collects urine and small amounts of mucus passed from the bowel conduit. The appliance is drainable and fastened with a bung or tap. The urostomy appliance is generally emptied 4–6 times daily and changed every day or two.