Urostomy Care - Topic Overview
Replacing your ostomy pouch
If you have a drainable pouch, you usually need to replace it every 4 to 7 days or whenever there is a leak in the pouch or itching or burning under the barrier. If you have a closed pouch, replace it when it is one-third to one-half full.
Prepare the new pouch and barrier. Cut an opening in the new barrier slightly larger than the stoma. You may also have a precut barrier. If you have a two-piece system, snap the pouch to the barrier. Remove the paper backing from the barrier so that the adhesive is exposed. You may need to put some skin barrier paste on the barrier if it does not stick well to your skin.
Remove the old pouch and barrier. Remove your old pouch by peeling away the barrier and gently lifting the pouch while pressing down on the skin below the pouch. Be sure not to irritate the skin as you remove the barrier and pouch. If the pouch is sticking and difficult to remove, use an adhesive remover underneath the barrier. Dispose of the old pouch and barrier.
Clean your skin. Clean your skin and stoma with a wet washcloth or wipe. You may use soap; if you do, rinse well. Allow your skin to dry and check your skin and stoma for signs of irritation. See the section below on treating skin irritation.
Measure your stoma, if needed. After your surgery, the size of your stoma may change. Your doctor may want you to measure it and will give you a measurement guide to help you do this.
Put on the new pouch. Position the opening in the barrier around the stoma and apply the sticky side to the skin. Press down until all edges are sealed. If your pouch is open-ended, attach the clip.
Treating skin irritation
The stoma is normally pink to red. Call your doctor if your stoma:
- Has a pale color.
- Is dark red or purple.
- Has moderate to severe swelling.
- Has moderate to heavy bleeding.
If the skin under your pouch is red, irritated, or itchy, you need to treat your skin. Follow these steps:
- Gently remove the pouch.
- Clean the skin under the pouch with a wet washcloth.
- Dry the skin.
- Sprinkle ostomy protective powder on the skin and then blot it off.
- Reattach or replace the pouch.