May/June 2002
Page 10
Temporary Ostomies
By Nancy Brede, RN, ET
Temporary ostomies are surgically created with the intent of reconnecting in the future. The anatomy of the gastrointestinal system or urinary system is left intact.
Permanent ostomies are created with the intent that the ostomy surgery will not be reversed: usually the anatomy in the gastrointestinal or urinary system has been removed.
Permanent ostomy surgery is usually performed when disease or injury prevents maintaining the anatomical structures needed for reversal.
A large number of temporary ostomies involving the colon are done on an emergency basis. The colon becomes obstructed or blocked, and stool cannot pass through. Because of the emergency nature of the surgery, the bowel cannot be cleaned and prepped ahead of time. Reversal, or re-anastomosis (hooking the normal anatomy back up), then can be done later, when infection is not as likely, and proper healing can take place.
The most common situations and diseases requiring a temporary ostomy are:
- Cancer of the colon with obstruction (or other abdominal cancer affecting the colon).
- Hirschsprung's disease; a disorder/malfunction in infants with prevents passage of stool.
- Due to lack of nerve cells in certain areas of the large intestine, stool is not moved through, and obstruction can occur.
- Trauma to the colon. Motor vehicle accidents, gunshot, or stabbing wounds perforate the colon, and an ostomy is necessary.
- Diverticulitis. Small outpouchings in the wall of the intestine, called diverticula become infected. The diverticula may rupture or cause obstruction.
- Inflammatory bowel disease (IBD) or Crohn's disease may necessitate temporary ostomy to allow the diseased bowel to heal.
Persons with the temporary ostomies face many of the same problems permanent ostomates have. It is just as important for them to have support, reassurance, and teaching as it is for persons with permanent ostomies. They must learn proper skin care, stoma care, and pouching techniques. Often, stomas are not ideally situated on the abdomen, because of the urgency of the surgery. Thus, pouching and skin care can pose difficult problems.
Following temporary surgery, measures need to be taken to improve the person's health. He or she must be in the best condition physically to undergo the major surgery for reconnection.
This is also a time for the person to psychologically deal with past surgery, upcoming surgery, and possibly a newly diagnosed disease. It may be a difficult time with all the changes and new challenges. Often, there are many fears and unanswered questions. Other people with ostomies and ET nurses may provide reassurance and the answers to many questions.
Via Rambling Rosebud and Ostomy Toronto, Sep 2001, via Inside Out On-line May/June 2002
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